Subpectoral Breast Implant Removal Technique

I have read questions regarding breast augmentation and if you are unhappy with the results, you can always take them out. Of course, doctors warn the more your skin stretched the less youll look like your original self, but that they CAN return to normal. I however am wondering, if you get implants under the muscle and somehow or someday decided to remove them without replacement, what happens to the muscle that was cut to fit the implant underneath? Can that be fixed, or does it heal itself? Does the muscle disintegrate?

Doctor Answers 31

Muscle function should not change


I agree that larger implants and greater degrees of muscle dissection from the sternum increase the risk of muscular deformity with contraction, but this is something that generally is seen with the implants in place. If this occurred while your implants were in place, then you are likely to have the problem after they are removed; if you did not have the problem with the implants in, you are unlikely to have it after removal- in other words, a well-performed breast augmentation should have a low risk of leaving you with muscular deformity or noticeable weakness, and therefore removal of implants placed during a well-performed operation should be low risk as well.

Naturally, the best way to assure you have the lowest risk possible of an untoward outcome is to be certain you see a surgeon Certified by The American Board of Plastic Surgeons, and ideally, that that surgeon also has significant training and experience in breast surgery.

Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Subpectoral implant removal and Pectoralis muscle

The answer to your question depends a lot on how the original augmentation was performed and what was done with the muscle at that time. Altthough we all use the term submuscular or subpectoral augmentation, in the truth the operations are not all exactly the same. There can be varying degrees of muscle dissection or release depending on surgeons preference, size of implant, and specific anatomic muscle variations in each patient. In general there is some thinning of the muscle in all patients but it does not disintegrate. Although the larger the implant, the greater the thinning of the muscle. If the muscle has been extensively released, it can potentially be sutured back down to the chest wall, but this is unlikely to result in a durable repair.

Braden C. Stridde, MD
Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews

Muscle changes after Implant Removal

Muscles are released to create a space into which the implant is placed.  How and how much of the muscle is release is very variable.  However, regardless of the situation, once the implant is removed from submuscular space (if it was placed under the muscle), there is no change in the way the muscle functions and feels.  If you were able to function with implants in, you will be able to continue after the implants come out.  The muscle will simply heal in it's place.

In my experience patients never complained about any muscle related issue after the implants were removed.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

It depends on how the initial surgery is performed

It is generally best to place implants in the subpectoral position because of better mammographic visualization of the breasts when compared to subglandular placement. They also look more natural and are less easy to feel because they are covered by more tissue. Finally, the capsular contracture rates seem to be less under the muscle.

That being said, there are many ways to create the pocket and how the muscle is handled will affect the answer to your question regarding the state of the muscle if the implants are removed. In addition, the size of the implant is critical because more muscle release must be done for bigger implants and larger implants will thin out the muscle more over time than more moderate sized implants.

By and large, though, "muscle issues" are not part of what a plastic surgeon ever hears from patients after explantation.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Subpectoral breast augmentation

This is an excellent question, what happens to the pectoral muscle after breast augmentation

What was done at the initial surgery will determine what happens after the surgery. If large implants were placed, the muscle is often separated from the breast bone (sternum), in order to produce more cleavage. Those fibers will never reattach, even if they are sewn back on with heavy sutures. When the pectoral muscle is used, the muscle can "jump"; it is contracting but doesn't know that it has been disconnected from the sternum. The more the muscle is detached, the more the motion artifact will occur.

Often, especially when large implants are used, the muscle atrophies, or becomes thinner. However the nerve supply remains intact.

Patients should consider the destructive effect on the pectoral muscle before having large implants.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Removing your implants

Occasionally, I see patients who just want the implants removed because they don't want the implants "to be a part of them" anymore.  Make sure you think about this and that this is the right thing for you.  It's difficult to say if you need a lift after removal -- no one will know exactly what your breasts will look like after the implants are removed until it is done. Talk to your surgeon and get good advice.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Muscle Repairs well After Implant Removal

The pectoralis (chest) muscle does repair itself well after implant removal, and does not require suturing or repair by your surgeon.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.6 out of 5 stars 39 reviews

Muscleafter implant removal

The muscle that was cut along the inferomedial aspect of the chest remaiins that way. Since it was stretched, it flattens out on the rib cage.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

What happens to the Pectoralis muscle after Submuscular Breast Implant removal?

The pectoralis muscle is split in the axis of its fibers to remove submuscular breast implants

The muscle will heal with or with out repair using this technique.

Fredrick A. Valauri, MD
New York Plastic Surgeon

Breast implant removal

Once the implant is removed, the implant pocket collapses on itself.  Gradually scar tissue is formed within the pocket sticking the muscle back over the ribs.  You do not have to do anything with the released muscle.  It stays in place as it heals.

Siamak Agha, MD, PhD, FACS
Orange County Plastic Surgeon
4.7 out of 5 stars 106 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.