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Reconstruction ‘PLANE CHANGE’ from under muscle to over muscle

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In 2015 I was diagnosed and had double mastectomy with reconstruction. At that time they recommended subpectoral (under muscle) implants as. Over the years the animation deformity when I flex has been annoying and uncomfortable. I am an active person a feel it every day. One side has started to droop noticeably and I am very self conscious.

Fast forward to today. I met with PS to discuss options for fixing. He said that 90% of the breast surgeries they do now are over muscle implants. (Geeze… when did they switch?!) He recommended doing a ‘plane change’ where they reattach pec muscles to chest wall and place implant OVER the muscles (pre pectoral). PS said they look great and he thinks I will be more comfortable.

I also discussed with my breast surgeon and she agreed the plane change would give me best results.

-Has anyone done a plane change? What was your experience?

-Opinions on over muscle vs under muscle? Is prepectoral actually the way they do it now?

I’m so over getting reconstruction on my breasts. What if they decide under muscle is better again in the future? I want to fix them, be comfortable, and have them as long as possible. I want to be confident in my decision.

Comments

  • moderators
    moderators Posts: 8,283
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    Hello, @sunnysky3! Welcome to our community! It's entirely understandable to have questions and seek advice, especially when considering a 'plane change' and the shift from under-muscle to over-muscle implants. We're sure other members here have gone through similar procedures and can provide valuable insights based on their experiences. For now, here are some of the articles from our main site that you might want to read:

    Breast Reconstruction Surgery With Implants

    Breast Implant Animation Deformity

    Breast Implant Displacement

    Hope this helps! Looking forward to hearing more from you soon!

    The Mods

  • abby11
    abby11 Member Posts: 2
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    Hi. I am going through the same decision making process. I had implant reconstruction 14 years ago, now have a small rupture in one implant, and need to get them swapped out. My surgeon says he can either replace the implants in the current under-muscle location or revise the pockets and put them over the muscle. I like the idea of over muscle location and wish that had been possible when I originally had the surgery. However, the pocket revision sounds like more difficult surgery, requires drains, more pain, etc. If anyone out there has had this surgery, could you weigh in? Also, anyone know the long term results, complications, of the revision to over-muscle implants? Many thanks!

  • sunnysky3
    sunnysky3 Member Posts: 3
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    Yes, if anyone has experience with a switch from under muscle to over muscle I'd love to hear your experience.

    I have a surgery scheduled for Dec 28 to do the plane change. I talked to my breast surgeon and she agreed that I should do it. While I am concerned about the longer recovery, the idea of not having the discomfort and deformity of the under the muscle implant is worth it to me.

  • 3mom
    3mom Member Posts: 10
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    Hello. I am 6 weeks out from what I just realized we now call “ plane change”! I had my “under the muscle” implants that were placed after my bilateral mastectomy 10 years ago removed and my muscles reattached to chest wall and now have tissue expanders and had my final fill today. In about 4-6 months I will swap out expanders for new over the muscle implants. It was a long decision. I was not sure I wanted to commit to 2 more surgeries. I also had no one really to talk to about it because no one I k ow has done this. I went to 3 different surgeons for opinions and the one I chose was very confident I would be more comfortable and happy and I am very pleased! My decision was based on the tightness of the original implants and animation deformity. I felt like they looked worse the more I exercised. Even with TE’s which are known for not being that comfortable I am already 90% better. The constant band like sensation is gone and they look so much better!

  • sunnysky3
    sunnysky3 Member Posts: 3
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    3mom - THANK YOU for sharing your experience. I have been searching for someone who has gone through this to talk to. I am encouraged to hear that you feel more comfortable with the over the muscle implants. That is my goal.

    How has your recovery been? How long were you laid up? Is the muscle reattachment very painful or difficult? I need to prepare my family for how long I will be out of commission.

    Interesting you have tissue expanders. Are you going bigger? My surgeon is not doing expanders with the plane change. Just one and done. He said I would need drains at first. Not looking forward to that.

    I did discuss this surgery with my mastectomy breast surgeon and oncologist. They concurred that most do over the muscle implants now and that I would definitely feel more comfortable.

    As my surgery date gets closer I am getting nervous. I am sick of breast surgeries. I just want to be comfortable and move on.

  • didisilver
    didisilver Member Posts: 1
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    Hello, I had a Bilateral Mastectomy in 2017. I had immediate reconstruction with silicone implants placed under the muscle. I've had a few revisions and now need a plane change due to pain. I'm very nervous about how much pain this will cause me AND how it'll look.
    All the ladies who send they were having surgery soon can you please share your experience with me?

    My surgery is scheduled for the end of April. I'm using the same silicone implants that I have. I've heard that most women like the appearance better. I'm hoping the same goes for me!

  • moderators
    moderators Posts: 8,283
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    @didisilver, welcome to Breastcancer.org, and thank you for your post!

    We're sure there are members who can share their experiences with this type of surgery and support, but in case you don't receive responses from the other members here (the tread has been inactive for a few months), you can always reach them via private message.

    In addition to this, there's also an active discussion specifically for those undergoing surgery in April. You might find it helpful to join that conversation as well. Here:

    Wishing you the best of luck with surgery. And remember, you can count on us for support at any time.

    Sincerely,

    The Mods