muscle flexing with implants out

[zuelkea]

I had unders 400cc silicone for only 3 weeks-i got an infection and had them explanted. I am now 7 months out of surgery-my capsules (very thin) were removed and the dr. irritated my ribs a bit so my muscle would scar down. He then sewed my muscle where it had been dissected. However, I now have pain and distortion when I flex. My muscle comes up at the crease-crease drags with it-up. and out a bit at the clevage area on the bottoms. It is painful. Some dr. say adhesions are causing my pain and distortion (skin/tissue stuck to muscle) 2 others say I need muscle repair and to sew my muscle down? It sounds quite extensive and costly. I have lost strenght and didn't notice this when i had the implants in. My sternum attachments where not overdissected and were intact. I would appreciate your expert opinion on what is causing this situation to occur?

[Dr. Mele]

Dear Zuelkea:

Thanks for you question. I wish I could help but this type of problem requires a complete history and examination. Where there was infection there will be scar. In your case the scar is gluing tissue layers together where the aren't normally well attached.

If your implants were removed from behind the muscle and the site was drained, normally, the muscle sticks down well. Where the skin is being pulled is the best clue as to the problem, and hopefully the solution.

There are too many variables to give you any useful advice. It could be any of the issues you mentioned. As a plastic surgeon in this type of situation, I have to be prepared for all options, including changing plans in the operating room depending on what is found.