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Monday, December 14, 2009 Boobear asks

Q: tissue expander placement

What determines if the tissue expander is placed under the chest muscle or on top of the chest muscle? I have been told that the standard procedure is to place the expander under the chest muscle. However in my case, it was discovered that my tissue expanders were just placed on top. I had bi-lateral breast cancer and opted for immediate reconstruction after my bi-lateral mastectomy. I am really confused!! Because during my last surgery, my new doctor that performed my surgery was not aware that my previous doctor had not placed the expanders under the muscle, I have been told that I may need to start everything all over again and have expanders placed under the muscle.

 

Boobear

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12/14/09 1:33pm

I'm not really sure why some doctors do it one way and others do it another.  I think it boils down to preference.....their preference.  And any good plastic surgeon will tell you that to get the most natural feel, the implants should go under the muscle.  Now why you would have to start over is beyond me, but I'm thinking it might be because the pocket between your muscle would need to be stretched before an implant can be placed there.  I can also tell you that the 'old' way of doing implants was to place it above the muscle.  I'm not sure when the procedure changed, but I'm thinking it was in the last 5 to 10 years.  Some surgeons are just stuck on doing it the old way cause it may be easier for them, or because patients are uneducated and don't know the difference between over and under to request them a specific way.  I can tell you that you would probably prefer them under.  I have mine under and they are real soft given the fact they are implants.

Good luck!

Angi

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By Boobear— Last Modified: 12/22/10, First Published: 12/14/09