Breast Implant Revision: Q&A

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Over or Under if I Try It Again~ 3rd Time

In 2007 I had 300cc implants put under the muscle and 6 months later had them replaced in the same area and the same size due to Capsular Contracture. I then had those taken out in March 2010 because of Snoopy Breast and CC. I'm 42 5'5 and 128lbs and am very athletic and flat! When the implants were removed so was the extra skin and it isn't pretty.I would like to have small(200-250)put in but not sure.Do I go over or under the muscle? With my history should I even try to do it again?

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6 Doctor Answers | Asked by running girl 42 in TX

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Revision Breast Augmentation with History of Capsular Contracture

I am sorry to hear about your past experiences. First, I'd like to address why capsular contracture may occur. There are several emerging theories explaining the possible etiology of scar tissue formation. Some believe the presence of a subclicinical (low grade) infection creates a "biofilm" (a film that develops around your implant) that evolves into scar tissue (capsular contracture). Others contend that the presence of small amounts of... more

Breast capsular contracture

I am sorry to hear about your problems. As I understand it, you had capsular contracture after both of your previous breast augmentations. If the previous augmentations were in back of the muscle, then unfortunately you seem to just form capsules. A switch to saline implants might be helpful if you previously had silicone gel implants, but this is more hopeful than probable. If the previous augmentations were in front of the muscle, it would be worthwhile to place implants behind the muscle.... more

Revision of breast augmentation

I am sorry to hear about your previous bad experiences. There are many potential causes of capsular contracture, some known and some unknown. With a more detailed history and physical exam, it may be possible to narrow down what might have caused the problem and potential ways to decrease the chances for recurrence. Based upon your height and weight, you will likely be better off with implant placement behind the muscle, and a "dual plane" augmentation should help... more

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It is impossible to tell you what to do without a more careful history and a complete physical exam. Some patients will have problems with capsular contracture whatever you do. For others, there is a specific reason for it to occur. In general, the smaller you go, the less side effects and complications and with thin soft tissue and a history of CC you are probably better of going under the muscle statistically speaking.

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Breast Implant Position?

Thank you for the question. I am sorry to hear about your complicated course after breast augmentation surgery. Generally, if at all possible it is best (in my opinion) to replace implants under the pectoralis muscle (dual plane). However, the major issue of concern is the overlying breast tissue and skin and whether further surgery will be necessary to achieve the aesthetic results desired. For example, some patients who have implants replaced into the sub... more

Over or under for augmentation

Sorry to hear about your multiple surgeries. Based on your history, I would still place the implants under the muscle (dual plane), which usually lowers the capsular contraction rate. Sometimes, we never know the cause of the capsular contraction. Good luck.

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Breast Implant Revision: Q&A

Over or Under if I Try It Again~ 3rd Time