“Rehabilitating Chest Muscles during en bloc explant surgery: Restoration and strength Insights.”

Exploring the rehabilitation journey for chest muscles is pivotal, especially after breast implants are removed (en-bloc explant surgery). Dr. Randall Feingold, an expert and co-founder of NYBRA (New York Breast Reconstruction and Plastic Surgery), sheds light on the challenges and the therapeutic processes involved.

Damaged chest muscles

To understand this process, we must know that breast augmentation often involves placing implants above or below the pectoralis major muscle, affecting the functionality of the arms and the ability of the ribcage to expand fully. During breast augmentation surgery, the plastic surgeon places Implants under the muscle, necessitating cutting through and lifting the muscle of the rib cage, altering its strength and geometry.

This alteration impacts movements, potentially leading to complications such as reduced shoulder range, chronic pain, and even breathing difficulties.

Implant below or above muscles?

The placement of implants, whether above or below the muscle, brings distinct concerns. While implants above the muscle may not weaken the muscle, they pose risks of capsule formation and reduced range of motion. Conversely, implants beneath the muscle result in tighter capsules, limiting chest expansion and impacting everyday activities.

Fixing the Damage

Dr. Randall Feingold explains the intricate en-bloc explant surgery, emphasizing the removal of capsules from the muscle undersurface and the rib cage. The surgery aims to restore the original muscle anatomy by meticulously reattaching the pectoralis muscle to the chest wall, ensuring functionality and comfort.

Recovery timeline

Recovery post-surgery demands a cautious approach. Patients are advised to avoid strenuous activities for at least two weeks to prevent bleeding and gradually resume exercises, focusing on not stressing the repaired muscles for up to four weeks: “After two weeks, I think the risk of bleeding from most major surgeries is shallow, and people can start walking more strenuously on treadmills or stair masters, going back to spin classes, or using light free weights. But in the case of people who have pectoralis muscle reattachment after a submuscular capsulectomy, they’re going to have more pain. They’re going to be a little more reluctant to go back to those activities, even at two weeks, even though I’m less concerned about bleeding at that point.

Be cautious and take your time.

 “I’m much more comfortable with people increasing their activities, as I mentioned,  but that doesn’t necessarily mean activities focusing directly on the pectoralis muscle. Suppose somebody wants to regain strength in that muscle. We certainly don’t want to tear that attachment to the chest wall. I would wait four weeks before attempting exercises like the pec deck, the bench press, or the pushup because that will focus all that energy on the front of your chest wall,” recommends Dr. Randall Feingold.

Finale note

It is essential to understand that every individual heals at their own pace; however, most patients report noticeable improvements in breathing and reduced muscle tightness post-surgery, signifying the benefits of restoring normal anatomy,” says Dr. Randall Feingold. Most patients fully recover within a few weeks to months, gradually regaining the full function of their muscles. 








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