Breast Implant Revision: Q&A
Ask a QuestionPossible to Replace over Muscle Implants with Under Muscle Implants?
I had silicone implants for many years under the muscle, had them replaced with over the muscle and don't like the look. Now I want to get them put back under the muscle, but I heard that once you get breast implants over the muscle, you can't go back to under the muscle. Is this true?
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21 Doctor Answers |
Asked by
anon
+2
Breast Implants and the Muscle
You situation is very complicated and you definitely need to be see by a board certified plastic surgeon that has experience in breast revision work. Having said that, you have been behind the muscle and now are infront and want to go back under. Easier said than done. It is not a technically difficult task but anatomically it may not be possible.
The muscle has probably window shaded up wards and you will likely not get any coverage of the implant any more. So really you are still going...
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Not True
Breast implant pocket position is changed often. I perfer under the muscle since the look more natural, in my opnion. This change shnould not be a problem
see video
San Francisco Plastic Surgeon
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Reopening pocket to reinsert implants under the muscle
In my experience, the pocket probably hasn't scarred down. Pockets persist longer than you might think. If this is the case, then gong back under the muscle is a matter of finding the edge of the muscle again, incising the capsule again and then inserting the implant below the muscle. It is a matter of careful dissection and I would expect the procedure to be longer than a primary breast augmentation but it is not contraindicated or highly complicated.
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Changing position of implants to subfascial
After multiple planes and surgeries there is only one technique that will deliver a beautiful shape and lasting result in my opinion, subfascial placement. I commonly use a technique called 'cold-subfascial placement' to correct undesirable results of multiply operated breasts with beautiful results. this technique allows the use of strong structural tissue in your body to create an internal brassiere to hold and shape the implant in a tear drop form. It also gives...
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Going back Under the muscle
Without examining you, it's difficult to say exactly what can/ cannot be done but generally, I would think that it wouldn't be a problem to go back under the muscle. I don't usually recommend sub-glandular (over the muscle) placement - I would be curious to see why you switched. Do your research regarding the surgeons you visit - make sure to choose a surgeon who is certified by the American Board of Plastic Surgery (not cosmetic surgery) and a member of the...
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Going back under the muscle may be difficult
When your implants were moved above your muscle, the prior submuscular pocket has problly scarred down and the muscle length has probably shortened. You have heard right, it many not be possible to back under the muscle and the muscle coverage alone may be very inadequate.
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Revision breast augmentation
This is unfortunately a problem we are seeing more often as the era of breast implants extends. Yes, it would be possible to transpose the implant back under the muscle however it may be challenging to elevate this plane and the muscle likely will be thin. There are porducts available that could help reinforce that submuscular plane that are commonly used in breast reconstruction that are acellular dermal matrices. That may be indicated in your procedure, but they are expensive....
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More challenging but possible
Now that both spaces have been created the anatomy of teh breast has been altered significantly. Understanding what you are trying to achieve is going to be the most important aspect of successful surgery.if you are thin and the implant is visible through the upper pole skin going to a submuscular position will help if your pectoralis muscle can be mobilized.
A new technique which uses dermis to hold the pectoralis in place and support the implant and the lower pole of the breast is an...
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Under the muscle after over the muscle
Dear Mimi54
You had implants under, then switched them to over now want them under again. In my practice I have seen this quite frequently. The implants can be placed under the muscle but a lot depends on what is found at the time of surgery.
Of course, not having examined you, I can't make a professional opinion. Sometimes, the muscle is thinned out and other times it may be thicker and more difficult to work with due to a previous capsule under the muscle that was not removed. Most...
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Changing "Overs" to "Unders" can be Challenging
As the other doctors have pointed out, a lot can happen with the muscle inlcuding shortening after release. I have also seen it become very thin after an implant has been on top of it for awhile. You really don't know a lor until the actual time of surgery.
Every case is different, and as long as you have a good reason to have the exchange, you should be able to get good results from a qualified surgeon.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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