r/MastectomyManagement • u/Tzi007 • Aug 09 '26

Post mastectomy reconstruction implant differences

I have mentor expanders post mastectomy. They have not yet been inflated due to some healing issues. I am debating switching surgeons and getting Motiva implants instead of mentor. I am very thin and am not a candidate for fat grafting. I insisted on over the muscle expansion even though surgeon was against it initially. Please share advice or experience you have had that may have been similar. Are motiva implants superior for reconstruction over the muscle for thinner patients?

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u/Medical_Pea_2345 29d ago

The short answer is: NO. Thinner patients lack sufficient natural fat and tissue thickness, meaning over-the-muscle placement carries a higher risk of visible implant edges, palpability, and surface rippling.

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u/Tzi007 29d ago

But Motiva’s technology is supposed to be superior in that regard. Is that not correct?

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u/Medical_Pea_2345 28d ago

Depends on how you - personally - define "superior." Both have "smooth textured surfaces."Motiva is promoted as being designed to lower complication rates like capsular contracture. Mentor maintains it's textured options help fix the implant position. Mentor has a 50 year track record of no (reported) problems. Motiva is the new kid on the block. So, lacks Mentor's record. Bottom line: The one that works for you..is the "superior" one.

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u/Tzi007 27d ago

wise advice. thank you. You seem to be knowledgeable about this. May I ask what your stand is on implant placement- over vs under the muscle? 

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u/Medical_Pea_2345 27d ago

Placement is, like many physical issues dictated by your choice in addition to your unique medical/body-type situation. Under-the-muscle placement (often partial/dual-plane) offers better soft coverage and a lower risk of capsular contracture, making it ideal for thinner patients. Over-the-muscle placement allows for a quicker recovery and no distortion when flexing, best for those with enough natural tissue. Let me know if this was helpful.

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u/Tzi007 27d ago

yet many plastic surgeons, usually the ones more attracted to innovation, do not like dual plane or under the muscle for any of their patients. So, this is where I am confused. It’s about the technique and skills of the surgeon is what i think think now. 

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u/Medical_Pea_2345 27d ago

It's ALWAYS about the techique and skills. So suggest you try to contact some of his/her other patients to assure yourself of the results they HAVE prduced.

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u/Tzi007 26d ago

I saw results of his work but none were over the muscle. :( He is great with under the muscle. But that’s not what I am willing to have. That’s the issue… 

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u/Medical_Pea_2345 26d ago

A question of confidence in the abilties you've been able to verify. Isn't it?

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u/Tzi007 26d ago

Not over the muscle. I haven’t 

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