What is the cost to change breast implants to be fully covered by muscle? I already have saline breast implants under the pectoral muscle, with the lower portion of the implants exposed. I have barely any breast tissue so rippling is a problem for me in the long-term.
Cost of Changing Breast Implants for Full Muscle Coverage?
Doctor Answers (8)
You need more tisssue over your implant!
This problem is one I frequently see.
There is no longer any way to put your implants totally behind the muscle.
You will need a large sheet of Strattice(TM) on each side to be sewn from the lower border of the pectoralis major muscle to the inframammary fold, maximizing the amount of implant that is covered by the pectoralis muscle, reducing lower pole stretch, supporting the implant, and adding lower pole coverage from the thickness fo the Strattice itself.
If you have droopiness, as is often the case, you may need a staged lift.
If you have saline implants, silicone would be better. if you have textured implants, smooth may be better. If you have standard silicone gel implants, highly cohesive implants may add some benefit.
Your problem is almost certainly due to some combination of your having little breast tissue/fat, thin/stretched skin, a muscle that has retracted upwards...these in turn are due in part to your own body habitus, the effect of what i bet was too large of an implant for your tissue, and a surgery that allowed the pectoralis to windowshade...
But that's just speculation. The point is that your problem is thin tissue coverage - and of all the things that need to be fixed in secondary augmentation - capsular contracture - implant malposition - skin stretch - size exchange - the one thing that we have the least ability to correct is thickening thinned tissue.
Options for rippling over lower and outer portions of breast implant following augmentation.
Although this can be done, it often creates a breast that is firm and rigid and somewhat immobile. We generally reserve full muscle coverage for breast reconstruction and rarely for cosmetic augmentation. When surgeons refer to full coverage in these instances, they are generally performing fascial coverage of the implant over the lower and lateral portions of the implant. To achieve full muscle coverage, one must elevate the serratus muscle. pectoralis minor or rotate the latissimus to cover the implant.
A more popular alternative is to use biologically derived collagen mesh matrices such as alloderm, strattice, surgiment, etc. This can be quite expensive for the material.
Another alternative is to consider the use of a silicone implant which has a lower tendency for rippling or a higher profile saline filled prosthesis.
Discuss these options with your surgeon to select the best choice for you.
Cost of changing breast implants for full muscle coverage
Full muscle coverage is an operation that went out of favor and is rarely done these days. The raised muscle (Serratus) caused a flattening distortion of the implant and uniformly wasted away to scar tissue.
A MUCH better way to get a better result is to switch to gel implants which feel more natural, are slightly lighter (IE sag less) and RIPPLE LESS. Then, use a biological scaffold (Alloderm or Stratice) sewn as a hammock from the edge of the pectoralis major is major muscle along the anterior and lower surface of the implant to the below the breast fold. This greatly diminishes the rippling but also slows breast implant sagging.
I hope this was helpful.
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Changing partial submuscular implants to full coverage
It is very difficult to reattach muscle after it has detached. A better way to give more coverage of the lower pole if you have rippling is to place a piece of allodern along the lower pole.
A better option to improve breast implant coverage
The lack of coverage of the lower and outer portions of the breast with implants under the pectoral muscle is related to the anatomy of the muscle. toal muscle coverage is really not a good option though, as it will distort the shape of the breast and is very rarely done for that and other reasons. Fortunately there is a good option, a material called acellular dermal graft (Strattice or Alloderm) which works very well in my experience. Info here: http://www.lifecell.com/patients/. The recovery is much easier and I would definitely encourage you to look into it before going to the total submuscular option.
Full Muscle Coverage in Breast Augmentation
Full muscle coverage is very seldom needed in breast augmentation. However, if this is truly the case the implants would need to be removed, the serratus anterior muscles elevated off the chest wall and advanced medially to cover the implants. These muscle are not very big so they may not provide you what you're looking for.
Another solution would be to add a dermal matrix such as Alloderm or Neoform or similar. The cost would be higher but it might be a better solution. Overall the total cost will probably run on the order of $6000-$8000 or more depending on where you go.
It would be virtually impossible at this point to get full muscle coverage of you implants. It is even very diffcult at the first go around. Your options would be
1. Switch to silicone gel implant, less rippling(but still may have some
2. Use Alloderm or similar product to add bulk to that area. This will be very expensive
3. Use fat grafting to the area. Somewhat controversial and will require multiple sessions
4. Try overfilling the implants-fairly simple, but will theoretically void the warranty and may not solve the problem
This is not a good option for you controversial
The idea of full coverage of the implant with muscle sounds good but it is impossible . We do this for the breast reconstruction but we use expanders and also Alloderm. Your muscle has retracted and will not stretch to cover the implant fully . You may benefit from changing your implant to silicone and also pocket revision. For the pocket revision the old pocket is folded on itself to provide more layers.
The other option is fat grafting to the breast . This a controversial and not all plastic surgeon offer it. I been doing this for the last 4 years and getting great results.
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