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Can I Go from Breast Implant Unders to Overs?

asked 3 years ago by zuelkea in fdl, wi. usa
Latest answer by Kris M. Reddy, MD, FACS
Question viewed 1,521 times
Tags: under muscle, over muscle, placement

I don't like the way the muscle feels over the implant. How will my muscles be affected if I had revision surgery?

14 answers to Can I Go from Breast Implant Unders to Overs?

Get evaluated by an experienced plastic surgeon first

Technically, changing the position of your breast implants can be easily done. There are advantages and disadvantages of placing the breast implants over or under the muscle. But, is this what is best for you? To answer this question fairly, a thorough physical evaluation needs to be performed by an experienced plastic surgeon to determine your best options.

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Implants are generally better under the muscle

In all of my primary breast augmentations, I place the implants under the muscle. In this position, they allow for more accurate mammograms compared to implants above the muscle, there is less capsular contracture, and the implants are less easily felt and look more natural long term. Moving your implants above the muscle is not only technically challenging in some cases but also loses all of the benefits listed above. Consider this carefully when making your choice and make sure you are... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

www.randcosmeticsurgery.com

Under to over

Removing a breast implant from under the muscle and placing it over the muscle is a serious step. First, the circulation between the pectoralis muscle and the breast is divided, forever. That means the breast and the nipple receive less blood. It makes surgery on the nipple riskier (of nipple loss, especially when a breast lift is performed, even years later). Also, it subjects a patient to a much greater risk of capsular contracture (hardening of the implants). There is also a chance that... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

You may be able to feel tand see the implant more easily

Placing a breast implant above the muscle is certainly an option for some women seeking breast enhancement, but it should be done in the properly selected patient who understands the advantages and disadvantages of this approach. Depending on your body type and build, you may see the ripples of the implant more easily and you may be able to feel it more easily. My advice would be to sit down with your surgeon and review your concerns, and give yourself plenty of time before considering a... more

Shahram Salemy, MD
Seattle Plastic Surgeon

Breast Implant Unders to Overs

While it is possible to change the implants from under the muscle to over the muscle, it should be rushed into. A thorough consultation to understand your motivation and objectives, and a physical examination would be necessary to confirm the proper recommendations for you.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon

Breast implants can be put over the muscle.

Hi. We have done this safely a number of times in New York City. With revision breast augmentation, a new pocket is made over the muscle, ant the muscle is then sewn back into place.

George J. Beraka, MD
Manhattan Plastic Surgeon

Implant positioning

Going from under to over with breast implants is a bit more difficult because the muscle is detached. It can be done, but not recommended in very thin patients.

Steven Wallach, MD
Manhattan Plastic Surgeon

You can

It is my opinion that under the muscle is generally the best way to go for many reasons. You may change position if you desire. I would ask how long your implants have been in, and what type they are (silicone/saline, smooth/textured), as this will affect how they feel to you. Generally, if you wait a while, they settle and feel more natural. Also, when you go over, the same variables apply. For the softest breast, you will want silicone, smooth implants. Every option you choose has... more

Scott E. Kasden, MD
Dallas Plastic Surgeon

Under to over is possible

Zuelkea, I don't know if anyone else realizes that you are asking a question or 2 every day and that you are only 3 weeks out from your surgery. I think if they knew, the recommendations to wait and to follow up with your surgeon would probably stand. You can go from under to over the muscle, trading off certain advantages and maybe a few disadvantages that you have with your implants in their present position. Please follow up with your operating surgeon, who really knows what would... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Changing implant placement is often a good idea

While over the past two decades, most implants have been saline filled implants and been placed under the muscle, I feel that now with the new cohesive gel implants most patients will have a much nicer more natural looking breast when they are placed through a peri areolar (around the nipple colored complex) and under the breast. I have often moved sub-muscular implants and placed them under the breast with great results. This is especially true if they have a moderate amount or more of... more

Carl W. "Rick" Lentz III, MD
Daytona Beach Plastic Surgeon

Unders to overs: What about the muscle?

To answer your question more specifically: The initial procedure likely released the attachments of the muscle to the sternum. Changing positions to over, will not undo this and attempting to "repair" the attachements is difficult to do (not always successful). Therefore, your muscles will not really be affected by changing positions. You may experience some relief in distortion of the implant with muscle contraction and you may feel less tension on the muscle. However, there... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

One is not better than another...

Breast augmentation is an imperfect operation that requires trade-off and compromises. Each component of the procedure (i.e. location, type of implants, style of implant, etc.) has advantages and disadvantages. Your surgeon should review all of these issues with you. However, to go from submuscular to subglandular is technically more involved than vice versa because the pectoralis muscle has usually been altered in some way. This may not be fully evident on examination or even by reading... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Over or Under Muscle Implant Placement

In most instances, it is better to put the implants under the muscle rather than over the muscle. Sub glandular (over the muscle) implants have a much higher incidence of rippling, palpability and capsular contracture. They also tend to look abnormally round. If your skin thickness pinch just above the breast is less than 1 inch, you should definitely avoid sub glandular implants. Subpectoral (below the muscle) implants generally look much more natural and have a much lower incidence of... more

John Squires, MD
Denver Plastic Surgeon

Changing implant placement is possible

Most people do the opposite of what you are asking, but it can be done. You should discuss your desires and concerns with your board certified plastic surgeon in detail. The last patient that I specifically recall going from under to over, was very self concious while working out in a gym. She had an implant on only one breast performed years ago by a now retired plastic surgeon, and when she would do a bench press, a crease would become visible on the breast until she put the weight down... more