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Breast Explant and Reimplant Under or over Muscle?

asked 3 years ago by cheeka Rae in sacramento ca
Latest answer by Jana K. Rasmussen, MD
Question viewed 7,488 times
Tags: breasts, bigger, rupture

24 years no scar tissue problems, currently placed on top of muscle. Both silicone implants are ruptured. I have very little breast tissue of my own. Getting conflicting answers for replacing under or over the muscle, lift or no lift.

I'm 46 years old, I don't feel like I need perky breasts and rather keep them over muscle I've been happy with them there. I've had 5 consults all different answers. Should I have new implants put in through nipple or as originally done bottom of breast crease? BTW I didn't realize how crooked they'd become.

7 answers to Breast Explant and Reimplant Under or over Muscle?

+2

Implant Exchange in Same Pocket Sometimes Yields Better Results

Your photo indicates that over the course of aging, gravity, loss of elasticity, pregnancy, weight fluctuations, hormonal changes (pick any that apply!), your own natural breast tissue has fallen off the mound of the implants. However, your nipple position still appears to be at or maybe just slightly below the level of your inframammary fold (which implies a lift is not imperative).  Many women use the need for surgical treatment of a ruptured implant as an... more
Jana K. Rasmussen, MD

West Palm Beach Plastic Surgeon
+2

It sounds like you have already made some important decisions.

The part of the procedure that every one would include is the removal of the old implants and the hard capsules. After this part, there are many ways to go. If you have considered the issues and risks of staying above the muscle then the new implants could be placed in the same pocket. Do you want to change the size? After the capsules are removed you will have a thinner amount of tissue covering the new implant and you may be able to see ripples from the implant. Do you want to... more
Marcus L. Peterson, MD

Saint George Plastic Surgeon
+2

No straight forward answer, only options

What you decide on doing will be determined by what you and your surgeon determine to be the priorities in the surgery and the risks or side effects you are willing to accept. The question of a lift depends on what amount of sagging or shape you are willing to accept. You breast soft tissues have stretcehd and sagged over the implants. If you simply replace them, there will be no change in the sagging. You might be fine with that if the price is more scars around the nipple. If not, you may... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

Re-do breast implant augmentation above or below muscle?

The decision should be based on your anatomy.   Since you have your breast implants above the muscle now and have had them done through an infra-mammary incision at the breast fold, it is reasonable to have them re-done using the same incision and same pocket above the muscle. At your consultation your board certified plastic surgeon will examine you and discuss your options accordingly.
Fredrick A. Valauri, MD

New York Plastic Surgeon
+1

Many options for breast explantation and re-implantation

Hello, Although I am not a big fan of over the muscle silicone implants (as they tend to harden up more over the long term,) it would make your surgery easier. Decide whether or not you mind your nipple position and either have a mini lift at the time or not based on your preference. Definitely get the old implants and the scar capsules removed though.
John P. Di Saia, MD

Orange Plastic Surgeon
+1

Many good options

The decision is so difficult because there are so many good options all of which will result in excellent results. Many of these options have been expressed in previous posts. From what you have stated, "I don't feel like I need perky breasts and rather keep them over muscle I've been happy with them there". That tells me what I need to know about pocket conversion. You don't need it. If you were having problems with implant distortion or capsular contracture then the... more
York Jay Yates, MD

Salt Lake City Plastic Surgeon
+1

It is basically your choice

It appears that you have pinchable breast tissue in the upper breast and you appear to be a candidate for an approch through your existing scar where the old implants and probably the capsule can be removed. Your breasts will be a bit saggier and you may possibly be able to see and feel the implant edges more easily. I also think you would be a good candidate for implant removal with possibly placing the upper part of the implant under the muscle and having a lift. You are a young woman but... more
Michael C. Edwards, MD

Las Vegas Plastic Surgeon

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