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Pectoral implants are an effective technique in men for augmenting the shape and size of the pectoralis major muscle. Inserted into the subpectoral plane through a high axillary incision, the chest can be augmented with minimal to no visible scarring. With today’ wide range of implant styles and sizes, many men’s chest augmentation needs can be met using standard implants.

But like all implants placed in the body, there is always the risk of the need for revision. Whether it is to change implant size or style, adjust the implant pocket to improve symmetry or treat an infection or seroma, the need to remove the implant to effectively treat the problem (and usually doing an immediate resinsertion of the old implant or replacing it with a new implant) is often part of the revision.

Revision of pectoral implants in which the implant has to be extracted from the pocket can be problematic for implant integrity. The ability to make a relatively small axillary incision for insertion, and the soft nature of the implant which allows it to be deformed and inserted, in the way in poses a problem on the way out. Since one can not climb inside the chest wall pocket and roll the implant up to extrude it back out through the small incision, the implant often has to be sectioned and taken out in pieces.

If the pectoral implant revision involves an implant exchange disruption the integrity of the existing indwelling implant is not an issue. But if the goal is to remove and replace the same implant as part of the revision, the patient needs to know this may not be possible or at least the implant integrity can not be assured during its removal.

Most pectoral implant revisions should have a new set of implants available, particularly if the need for implant replacement is not preoperatively planned.

Dr. Barry Eppley

Indianapols Indiana

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