Is it necessary to attach the muscle to the chest wall when removing an implant that was placed under the muscle? (photo)

Question

I had an breast explant last week and my doctor attached the muscle to the chest wall; so much so that my breasts (especially one) is completely deformed. The natural fold under the breast under one is almost two inches higher and the nipple subsequently turns under. He refuses to discuss the matter, stating that it is supposed to be this way. I researched this for two years and know this is not normal. Is there any way to correct this? What would you recommend I do?

Lu-Jean Feng, MD · Answer

I think the deformity you are experiencing is only partly related to repairing the pectorals major muscle back to the chest wall. What you have is scar tissue still attached to the bottom part of the breast and skin. You can wait until the scar soften over time which can take about a year. Or, if the scar tissue is scar capsule, you will need to have your breast tissue released from the scar which may be still attached to the chest wall. In other words, you need a scar release. I have a lot of experience with this problem. Please be assured that it can be corrected.

David Liland, MD · Answer

Implant removal can lead to breast deformity due to the implants effect on the surrounding tissues over time. It is hard to make a comment without a physical exam.  Hopefully a capsulectomy was perfumed. The pec major muscle could have run inferior to the nipple areolar  and by attaching it to the chest wall resulted in tenting the breast up under the NAC in a standing position that is hard to detect in the OR. Simple release of this attachment might correct the whole issue. Most definitely discuss your situation with your PS and state your concerns.

John Michael Thomassen, MD · Answer

It is possible that the muscle is causing this deformity through action on the capsule that is attached to subcutaneous fat.  Does the deformity worsen with muscle contracture?  If so, then a muscle release may be necessary.  Either way, a lift would be necessary to correct your breast shape and nipple position.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Leave that reattaching your pectoralis major muscle to the chest wall has nothing to do with your breast deformity.  I would recommend just a normal breast reduction to improve the size and shape of your breasts

Steven Wallach, MD · Answer

Removing breast implants is unpredictable in terms of how the tissues heal around it.  Best to give it time to settle down. Good luck.

Is it necessary to attach the muscle to the chest wall when removing an implant that was placed under the muscle? (photo)

Answers (5)