I had my second BA 8 months ago with 560cc high profile overs and my results is sitting too low and visible rippling. My surgeon is also unhappy with my result and is offering to re-do my surgery as she is very disappointed and knows I am unhappy. She wants to switch to 600cc unders and says I won't need a lift however I am extremely apprehensive as I am worried I will have excess skin hanging off the implant if I switch to under the muscle with only a small increase in implant size.
Implant Exchange from Overs to Unders?
Doctor Answers (9)
Implant Switch to Unders and Lift
The implant plane switch from subglandular to submuscular may produce more droop and frequently does. Kenneth Hughes, MD Los Angeles, CA
Rippling and implant position
Going under the muscle would certainly camouflage the rippling in the upper pole but you will still have it in the lower pole. If you really want to resolve your rippling, you could consider textured anatomic gel implants on top of the muscle (with its certain drawbacks) or smooth round gel implants under the muscle accepting the muscle movement and other known risks of gel implants. Your surgeon really needs to decide if your size is compromising your result and possibly downsizing even more could be of benefit to you. Talk to your surgeon and allow them to help you navigate this maze of choices.
Revision breast surgery
Without photos it is difficult to give an opinion. Frequently pocket change will help to decrease rippling. Sometimes a lift may be required for excess skin and an acellular dermal matrx may be needed for support. Donald R. Nunn MD Atlanta Plastic Surgeon.
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Over or under???
It will be fantastic to see your pictures because it is difficult to know how much skin is sagging and ifvthe new implant will fit under the muscle and if the skin will expand with it
Rippling After Subglandular Breast Augmentation
I think moving the implants to under the muscle is a great idea to address the visibility of the implants (rippling). I would wait about 3 months if you can stand it - the reason is that this is about how long there is swelling and you will get results you can count on better if you wait until that time. Regarding the lift - You really need a lift if your nipple position is lower than your breast fold or if you have excess skin. The slight increase in implant size is to keep you about the same size (your muscle pushes the silicone implant and makes it look smaller). Good luck!
Implant Exchange from Overs to Unders?
There is not enough info here to give a useful response. It does make sense to move these to sub pectoral position because of the ripples. If they are in the top half of the breast, that may resolve the issue, but if they are lower, adding an acellular dermal matrix such as Strattice may be a good choice.
I would have to see photos to comment on the issue of how low the implants are, and the possibility of excess skin.If the implants are low, simply moving them to the sub-pectoral plane will not be the solution.
Consider posting photos for more specific responses. All the best.
Moving Implants Under Muscle Should Improve Rippling
Moving your implants from above to below your muscle should lessen the chance of rippling. Be warned, however, that 560-600cc implants are extremely large and using these very large implants will increase your likihood of multiple problems.
Over to under changes
As Dr. Wallach mentioned, without seeing you, it is difficult to give you a specific answer.
Generally, there is some looseness of skin noticed for patients when they switch from over to under.
If your skin is tight now and there is NO sagging, then generally speaking, you may not need a lift.
i would agree to going up a little in size since under the muscle implants tend to look a slightly smaller and less obvious than over the muscle implants.
are your current implants saline or silicone?
for rippling the silicone are generally the better option.
Hope that is helpful.
Bennett Yang, MD