What happens to the pectoral muscle post explant?

A lot of how the initial surgeon did the dissection was important along with if you have a capsular contracture, you could have a neuroma, along with malposition of the implant; along with the implant sitting on the nerve, among many other reasons that could account for pain. So when your pectoral muscle was cut, it was never sutured down, it will lift up and again, dependent on your surgeon’s technique. The goal is to not cut the muscle and to remove the implant below the muscle and leave everything intact.

Hello @ivrn1, thank you 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. If you are considering a breast explantation, consultation with a plastic surgeon who is experienced in this procedure is essential to ensure optimal results. 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)

After implant explantation, the pectoral muscle will scar back into its original position. It would be highly unlikely this would cause any nerve issues. I suggest you see your doctor to discuss these issues.

The pectoral muscle does not reliable re-attach by itself, and I have seen many cases of animation deformity persisting after implants were removed. It should definitely be re-attached.

In best case scenario, your surgeon should try to reinsert muscle and attach it to a sternal bone and, if possible, some ribs. Very likely it is impossible to stretch muscle that was partially retracted for 20 years, but reattachement will create more symmetry. It would be very hard to prove that implants are causing your pain, considering your history of shingles. Hope this helps.

Dear ivrn1,
generally speaking, implants are removed and muscles are left as they are. They are not reattached back to their origins since only a small part of the muscles was released. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

When breast implants are removed (explantation), especially if they've been in place for an extended period, the pectoral muscles might undergo some changes. The pectoral muscles are located underneath the breast tissue and play a role in providing support to the breasts.Here are some general considerations regarding the pectoral muscles post explantation:1. Muscle Stretching and Contraction: Over time, the pectoral muscles may adapt to the presence of breast implants. When the implants are removed, the muscles may undergo some stretching or contraction as they adjust to the changed circumstances.2. Recovery and Healing: The extent of changes in the pectoral muscles can depend on various factors, including the duration of time the implants were in place, the size of the implants, and individual factors like muscle tone. In many cases, the muscles can recover and regain their natural tone and function over time.3. Exercise and Rehabilitation: Engaging in targeted exercises prescribed by a healthcare professional can help with the recovery of the pectoral muscles. Strengthening exercises can be beneficial in restoring muscle tone and improving overall chest aesthetics.4. Individual Variability: The degree of change in the pectoral muscles can vary from person to person. Some individuals may notice minimal changes, while others may experience more noticeable alterations.It's important to discuss these concerns with a board-certified plastic surgeon who can provide guidance based on your specific situation. Additionally, if you have any postoperative discomfort or changes in muscle function, it's essential to communicate with your healthcare provider for appropriate guidance.Overall, the body has a remarkable ability to adapt and recover, and with time and proper care, the pectoral muscles can undergo positive changes post explantation.

With regards to the pain, it is almost impossible to guarantee that that pain will be improved upon after removal of implants. However, often this is the case. It surely is my hope that you can have relief after your implants are removed. With regards to the pectoralis muscle, sometimes the pectoralis muscle is tacked back down to the chest wall, however, given the dynamic nature of this muscle, it often will pull away from the sutures if this was attempted. However, more often than not it lays into a position similar to how it was before the surgery and also in a position that allows the continued functionality that you had even while you had an Implants. If your implants are causing you discomfort or distress than removing them as often a good option. You may require a lift due to the lack of volume that results. Have a conversation about your goals with a board-certified plastic surgeon. We are happy to help in any way we can.

When the implants are removed the muscle is generally not surgically reattached, which typically is not an issue. The nerve pain you describe is not common after breast augmentation. It would be difficult to determine if it was related to an implant, shingles, or some other factor. If you are interested in having your implants removed, see a board certified plastic surgeon near you to learn more.