Implant Exchange - Am I a Good Candidate for Smooth Silicone Subglandular w/ Lollipop Mastoplexy?

I'm an Athletic Yoga Teacher. I Want to Trade my Saline (Under Muscle) for Silicone (Over Muscle) and Shrink/even Up my Areolas. I got saline submuscular implants & crescent lift nine years ago. Initially I was happy with the result, as it was a big improvement. I've now had two more babies that I nursed (briefly) & some significant weight fluctuations. Now I'm in great shape but hate the way my implants SQUASH down when I flex my chest & feel way too firm/fake. I also hate my areolae, they're asymmetrical and WAY bigger than I'd like. Am I a good candidate for smooth silicone subglandular w/a "lollipop" mastoplexy?

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9 Doctor Answers | Asked by flowergirl83 in Salt Lake City, UT

Doctor Answers (9)
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Breast Revision

One risk of the crescent lift is that the areolas stretch out again over time. You also have capsular contracture (bad scar tissue that forms around the implant) which can be repaired by removing the capsule - that will make your breasts look and feel much more natural. From your pictures, it looks like you would be a candidate for the lollipop or vertical breast lift.

Subglandular silicone implants

I think you are a good candidate for subglandular implants to avoid the malposition that happens with flexing your muscles. Silicone would be my first choice. You may also benefit from a capsulotomy as you appear to have capsular contracture. Because of your weight fluctuation you may have stretchy skin so you could benefit from a vertical lollipop mastopexy. Best of luck

Implant exchange and pexy

I would not recommend placing the implants under the gland. You have loss of suppoort causing ptosis. The muscle gives the best support long term. I would recommend larger diameter implants, perhaps low profile implants or moderate profile implants plus a full mastopexy. There are always compromises and I believe that long term under the muscle is the best way in this instance. sek

Changing implant position

You could get a much better look with new implants. If you go above the muscle, go with gel for sure. Either way, you need a much wider implant than you have to close the huge gap in the middle. Maybe just a periareolar lift will be all you need to shrink the areola because you don't look like you have that much extra skin and much of that will be draped over the bigger wider implants.

Breast augmentaiton and Lift

Yes changing your implant position and type are a good idea. You may be tempted to just change the implants and forego the mastopexy. In my experience that results in breast that sit lower on you chest wall and not really the perkiness that an athletic person wants. I do therefore recommend the masopexy.

Implant exchange

By placing your implants in a position above the muscle, you may get more cleavage so your breasts will not look as far apart. Smooth silicone implants are a good option for you as you appear to be thin. Depending on the size you choose and the position of the implants, you may not need a breast lift with a vertical scar if the areolas are being reduced. Your surgeon may make a decision during surgery based on how things look.

Breast implant revison

There are definitely advantage to each location of the implant. How that will look will depend on the quality of the soft tissue and skin of you breast.

Peripexy with implant exchange

It is not uncommon to need a little perk up after 2 pregnancies. I definetely would keep the implants under the muscle as I agree that the muscle gives long term support and prevents bottoming out. Silicone implants also seem to "bottom out" less long term. If you want to reduce the nipple-areola size, you will need at least a periareolar incision- ie; an incision all the way around the nipple-areola complex. This can devascularize the nipple so it may not be... more