Implants placed below the pectoralis muscle in the chest wall may be more likely to contract, causing pain or movement from their original position.
Breast implants placed below the chest muscle, also known as retropectoral placement, are prone to certain implant-related issues including pain and animation deformity.
When placing implants below the muscle, the pectoralis muscle is cut to create a pocket for the implant. The pocket that is created helps to hold the implant in place to some extent and to provide added tissue over the implant. However, the cutting of the muscle can sometimes create chronic discomfort or pain in some women.
Additionally, implants that are placed below the muscle may experience animation deformities. This is movement of the implant that occurs when the pectoralis muscle is contracted. Since the pectoralis is the major muscle of the chest wall, it is contracted frequently. Animation gives the breast an unusual movement and appearance.
Converting implants to above the muscle requires adjusting the placement of the implant. Above the muscle is also known as prepectoral placement. This positioning is typically far more comfortable for women who experience pain or discomfort from their breast implants.
If breast implants are converted to above the muscle placement, a secondary fat grafting procedure will often be required because the remaining breast skin is often thin. Fat grafting helps to increase tissue thickness over the implant and to smooth out the appearance of the breast.
Above the muscle placement works best for women who have adequate soft tissue above the muscle to provide coverage for the implant.
Implants with above the muscle placement incorporate acellular dermal matrix (ADM), a type of collagen sheet, that is wrapped around the implant to hold it in place.
Potentially. Women with thin or damaged skin in the breast area may not be good candidates for above the muscle placement without the addition of non-radiated tissue. These women may be better suited for a hybrid reconstruction that incorporates a tissue flap with an implant.
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