Can You Change Implants from Over the Muscle to Under the Muscle?

I currently have over the muscle saline implants. I have the normal wrinkling but when I lay down one goes under my arm and is uncomfortable. Would like a more shapely round looking breast. Can I move them to under the muscle after having them over the muscle?

Doctor Answers 10

Changing Implant Location

Yes. This procedure is relatively common, especially in patients that have recurring issues with capsular contracture. Placing the implants underneath the muscle will help to mask the wrinkling and rippling, and will also contribute less to breast sagging over the years as compared to implants placed over the muscle. If your breasts are falling into your armpits when you lay down, it is possible that you have issues with the pockets created during your initial surgery. Placing the implants under the muscle will allow the surgeon to create new pockets, which could give you a more ideal cosmetic result.

Converting breast implant pockets is not easy

To convert a subglandular (over the muscle) to a subpectoral (under the muscle) position, is easier said then done.  It does depend on how long the implants have been in place.  If they have been in for several years, what happens is the pectoral muscle becomes attenuated or thinned out making it very difficult to elevate and create any type of significant muscle coverage.  When the muscle is elevated if often displays a "window-shade" phenomenon where the muscle migrates upwards, effectively not covering the implant at all.

It is possible to do, but depends on the particular patient and her anatomy and duration of current implants.

You should consult with a board certified plastic surgeon prior to scheduling this type of breast surgery.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 228 reviews

Over to under is possible in experienced hands.

The surgery you require consists of multiple steps and interventions involving many choices such as capsulectomy, capsulorrhapy, suture fixation, saline to silicone transition, etc. This is a complex operation that can and should be performed by an experienced board certified plastic surgeon. You may want to obtain multiple consultations in this regard. You will be at higher risk for complications such as "window shading" and/or the need for a touch up.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 58 reviews

Implant pocket site change

Of course it is possible to change implant pockets from over to under the muscle. It is also desirable to do this when rippling is visible. However, loose breast skin may need to be tightened in the form of a breast lift, to establish a normal, attractive breast contour.

Implant Site Change Possible and Very Common

It is very common to change the implants from subglandular to submuscular, since it provides better coverage over the top of the implant.  This can also help hold the implant in a more centered position and keep it from falling.  It does require some work internally, and you need to close off that pocket above the muscle so that the implant does not flip back above it in the post-op process.  This is easy to do with some internal sutures, but requires a little finesse.  I hope this helps.

Changing the implants from over to under the muscle

Changing the implants from over the muscle to under the muscle is quite common.  This is often done to camouflage the upper pole of thr breast.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

Change implants from over the muscle to under the muscle.

Yes.  This is done for a variety of reasons.  The advantages of under the muscle include a more natural look as there is more tissue coverage, and less capsular contracture.  If you have large implants on top of the muscle, you may have redundant skin that may need to be addressed with a breast lift pattern technique.  As far as your implant moving.  the creation of a new pocket may help this.

As with any procedure, especially a "Re-Do" or revision, there are benefits and risks.

Best to see a board certified plastic surgeon for evaluation and possible treatment.

Jeffrey Roth, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 12 reviews

Switching Pockets for Breast Implants

Implants can be placed beneath the muscle if they were once over the muscle.  This would decrease the visible wrinkling and decrease the potential for capsular contracture.  Concerning the implants falling into your armpits this is a function of creating a pocket that is not too wide.  

Dr. ES

Moving Implants under Muscle

You certainly can have your implants moved from an over the muscle to an under the muscle pocket, which is the location I routinely place breast implants.  I am not sure that this would give you a rounder breast but it should help with wrinkling problem and give a more normal appearing breast.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Site change to below the muscle

Every case is different but it is a common practice to perform what is referred to as a site change to a partially below the muscle position. The benefits are more coverage of the upper, inner and sometimes the lateral breast. The typical patient that benefits from this procedure does not like the rounded unnatural shape of the above muscle implant, especially in the thin patient with some degree of capsular contracture.

I hope this helps

Dr Edwards

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.