Consequences of muscle not being repaired after explant?

Question

Is pec flex deformity the only consequence to not having the pec muscle repaired after explant or can there be other problems with the muscle? I had my implants removed 7 yeara ago but recently have pain near the fold that feels muscular as well as burning pain. Can sagging from age make the muscle compromised or burny?

Alan Gonzalez, MD, FACS · Answer

Hello @ffwife, thanks for your question! The pectoralis muscle generally has the ability to return to its condition in a short time. When breast surgery is done and part of the breast is placed behind the muscle while the rest is placed on the outside of the muscle, when aesthetic reconstruction (reacomodation of mammary tissue to give breast projection with BRALAN technique) is done, unless there is a pathology that prevents this from happening or a rupture or something special, the muscle may return to make the contraction and stay in place. Best wishes!

Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS), International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Alan Gonzalez MD, FACS.   American Society of Plastic Surgery Member (ASPS),  International Federation for Adipose Therapeutics and Science” Member (IFATS), Colombian Society of Plastic Surgery member (SCCP)

Shaher W. Khan, MD · Answer

Hello, thank you for your question. It sounds like you are experiencing some discomfort after your explant surgery, and your concerns about the pec muscle and related issues are valid. Let's delve into the potential concerns in the attached video. While pec flex deformity is a notable concern when the pectoralis major muscle is not repaired, other issues can also arise that may lead to discomfort and pain. Your symptoms could stem from a combination of factors related to muscle function, aging, and potential scar tissue development. It's important to seek professional evaluation to determine the underlying causes and appropriate treatment for your symptoms.

Bryan Curtis, MD · Answer

If muscles are not adequately repaired after breast explant surgery, several consequences may arise. The pectoral muscles, which are often affected during breast implant removal, play a role in chest wall support and movement. Failure to repair these muscles properly may result in:1. Muscle Weakness: Incomplete repair can lead to weakness in the pectoral muscles, affecting overall chest strength and stability. 2. Reduced Range of Motion: Improper healing may restrict the range of motion in the chest and shoulders, impacting daily activities and exercise.3. Cosmetic Issues: In some cases, inadequate muscle repair can contribute to changes in breast shape or contour, affecting the cosmetic outcome of the surgery.4. Chronic Pain: Insufficient muscle repair may lead to chronic pain, discomfort, or muscle imbalances in the chest area.5. Functional Limitations: Poor muscle repair may result in functional limitations, making it challenging for individuals to perform certain movements or activities.It’s crucial for individuals undergoing breast explant surgery to follow post-operative care instructions, including rehabilitation exercises, to promote proper muscle healing and minimize potential complications. Consultation with a healthcare professional is essential to address any concerns and ensure a comprehensive recovery plan.

Mats Hagstrom, MD (license on probation) · Answer

I think you’ve asked similar questions in the past. It’s really not possible to repair the pectoralis muscles during explantation after breast augmentation. I’m not sure where you got the idea that this is some kind of standard of care for an appropriate procedure to be done.
I’ve never heard of a plastic surgeon, attempting to repair the cut part of the pectoralis muscle during removal of breast implants. The muscle edges become incorporated into capsule tissue and attempting to realign edges of the pectoralis muscle will cause disfigurement intention inside the capsule.
Explantation should not create long-term chest pain, and if you’re having symptoms, it is most likely from another ideology.
That said any, and all surgical interventions can create body sensations that are different from the physical aspect of surgical intervention.
Most people get a custom to the changes after surgery, and the new sensations become the new normal.
Those who continue to believe that there was a problem with the procedure, or that the procedure was the cause of an ongoing problem are more likely to continue experiencing symptoms.
This is the primary basis of breast, implant illness.
Anyone who believes cosmetic surgery has caused irreparable damage will continue to have ongoing symptoms.
The placebo effect is extremely powerful.
In that sense, the symptoms are quite real.
I don’t think there is a plastic surgery approach to your concerns, and there is no indication for further surgery based on what you describe. 
I apologize in advance if my response seems blunt and unsympathetic.
I’m a big advocate of being honest with people. 
You can’t undo the decisions of the past, so I suggest trying to move forward.
Best,
Mats Hagstrom, MD

Consequences of muscle not being repaired after explant?

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