Is it possible to have pec muscles repaired after bilateral capsulectomy?

In performing explant Procedure, the capsule is removed, and the muscle should not be damaged. There would be no need to repair the muscle unless there are serious Damage to the muscle from previous surgery. Hope this helps.

I am very sorry that you are not feeling well. When an implant is placed behind the muscle, the attachments to the breast bone are left intact. The fibers that are attached to the ribs are usually completely or partially divided. So the pectoralis muscle is still very functional. Therefore, a muscle repair is usually not needed. If your muscles were overly dissected, then it can be addressed at the time of surgery. Good luck!

As a general concept, the capsule is removed from the under surface of the muscle and if possible from the chest wall. If there has been minimal manipulation of the muscle it can be reapproximated.The value of this maneuver is of questionable value as the insertion of the muscle on the rib provides little additional function. The body will heal with scar tissue which will naturally reapproximate the muscle to the chest wall.Good luck with the procedure and I hope this resolves your illness.

Thank you for your question!  Performing en bloc explantation with capsulectomy can be a very difficult procedure to be performed.  Separate from the explantation, exists whether the pectoralis major muscle needs to be repaired.  Well if you are having issues with your current breast implants, you probably are not going to get new implants.  As a result, repairing the muscle may not have any improvement in your function unless it was significantly damaged.  Normally, during your primary breast augmentation, the surgeon will release some of the fibers of the pec. major muscle.  The question I have for you is, did you notice much difference in your strength once you recovered from your original operation?  If not, then attempting to repair the muscle during your explantation may not gain you anything.  If the muscle retracted over the implant, then during the explantation, I would look to see how mobile the muscle is and determine if I can reattach it to its insertion.  I hope this helps!

Thanks for the question.  There are a lot of women seeking information regarding explantation and what else can or should be done.  I will quote a letter from the American Society of Plastic Surgery to all of it's members regarding the issue of breast implant illness (bold face type added by me for emphasis)."There are many medical inaccuracies perpetuated by the internet. BII patients tend to believe that a total capsulectomy is necessary to remove all causative agents and they prefer it en bloc, oftentimes without having a full understanding of what size incision is necessary for en bloc. Rather than react, first discuss the reasons you would perform a total capsulectomy with any patient. Not all plastic surgeons routinely perform a capsulectomy with explant, but some do.If you wish to perform capsulectomy on a patient, it is important to explain that it is not always possible to remove all of the capsule. Sometimes a portion of the capsule must be left behind or is disintegrated with the use of electrocautery to prevent significant damage to muscle, rib or lung. Explain what size incision is necessary for an en bloc (as many may not be aware of how large an incision may be necessary). If they had an axillary approach or periareolar approach for breast implant placement, it must be explained to them that they cannot have the procedure done through those incisions. It is recommended to reinforce that there are increased surgical risks associated with en bloc capsulectomy which requires a complete dissection of all the tissues surrounding the breast implant and, that we do not have enough collective data to guarantee any improvement in their symptoms they have labelled Breast Implant Illness (BII)."The en bloc capsulectomy requires at least a 15 cm incision (6 inches).  The only complications I have seen from removing implants are in patients that desire to have the scar tissue removed.  Hemorrhage (bleeding), hematoma, and seroma (fluid collection under the skin) are all common after capsulectomy.  Capsulectomy can also cause a very irregular breast shape if scar tissue tethers the breast tissue to an abnormal position on the chest wall (can create a very obvious indentation or fold in the skin).  There is also a significantly higher chance of permanent loss of sensation with capsulectomy.  I have never seen any of those complications in a patient where I removed the implant and left the scar tissue (capsule) behind.  There is also no data or evidence that removing the scar tissue is any more beneficial than just removing the implants.If you perform a total capsulectomy you could repair the pectoralis muscle by suturing it down on the chest wall, but it can never be restored to its original position.  The position on the chest wall where it would heal is basically identical to the position of the muscle underlying the breast tissue.  Therefore there is no increased strength or benefit to repairing the muscle.I explain all of these things to my patients requesting implant removal, and almost without exception I encourage them to have the implants removed in my clinic under local anesthetic.  If patients still want to have the scar tissue removed then I will still perform the surgery.  I have even more information on my webpage link below (scroll 2/3 of the way down the webpage to see information regarding implant removal and breast implant illness).

If the implants were placed under the muscle, and the muscle was partially released as is most common, then the muscle has probably shortened and retracted over time. In most cases, it would be impossible to restore the muscle to its original form.

This answer greatly depends on whether your implants were placed under or over the muscle 
If under the muscle then yes it is possible to repair the muscle. This is sometimes done by surgeons depending on the intra-op evaluation of the breastpocket/muscle. 
I dont routinely re-insert the muscle back into the rib cage where it was released from but i do suture it back into roughly the same area. Many times these sutures break or release but its worth a try to have things as anatomical as possible plus it tends to help collapse dead space after capsulectomy
Cheers and good luck

Things can be assessed at the time of surgery.  In general when a capsulectomy and implant removal is performed the muscle is not repaired and technically it may not be possible.  In certain cases where the muscle was extremely retracted or "rolled up" I have brought the muscle down and sutured it back to the chest well.  This can in some patients help with the contour deformity that some patients experience after implant removal (in particular patients that have thin soft tissue coverage.Hope that helps.

Hello, and thank you for your post. If your breast implants were placed below the pectoralis muscle, part of the muscle will have been detached from the rib cage to create a pocket for the implant. Though studies show that the majority of women do not experience lasting damage or muscle weakness from this technique, other concerns like muscle division or separation may arise over the lifetime of the implants. The capsulectomy itself — even en bloc — should not require any further muscle detachment, and your surgeon may be able to correct any muscle separation with sutures to encourage muscle repair. 
If you do undergo a muscle repair, you will need to take a break from upper-body exercises for at least a month after your procedure. Be sure to schedule your surgery with a board-certified plastic surgeon who regularly performs explant procedures; this will ensure your safety and a smooth recovery. I hope you are feeling better soon!

Thanks for your inquiry, the pectoralis muscle is generally not repaired after capsulectomy in many cases there may be no place to anchor the muscle in terms of the rib and sternum. Good Luck with surgery.