Breast Implants: Q&A
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Above or Below Muscle?
does placement of breast implants matter when trying to avoid a repeat episode of capsular contracture?
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23 Doctor Answers |
Asked by
beth5062
in nj
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Subglandular or submuscular?
Thank you for your question. The choice of pocket (over or under the muscle) depends on many factors including patient anatomy, lifestyle, and patient choice. The most common location is submuscular. There are many studies to suggest that a submuscular location decrease the rate of capsule contracture. Some other studies suggest that an acellular dermal product such as Stratttice can decrease capsule formation as well. These products are generally reserved for...
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Capsular Contracture and Breast Implants
Most implants are placed under the muscle, particularly if they are smooth. If the first implant was placed over the muscle, then a change of plane to under the muscle could be performed. If the original implant was placed under the muscle, a new implant can be placed in a new pocket between the anterior capsule and the muscle or total capsulectomy can be performed. Anterior capsulectomy alone results in greater recurrence rates, and open...
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Typically yes...
Typically yes. It is generally accepted that after a capsular contracture the new breast implant should be placed in a new pocket if possible. This is achieved either by converting subglandular to subpectoral placement or in the case of a previous subpectoral placement, a capsulectomy can be performed to freshen the pocket for the new implant.
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Submuscular for subglandular for cc
In general, submuscular placement has been shown in multiple studies to have a lower rate of CC.
However, I would also need to know your personal history - how many surgeries for breast augmentation have you had, which plane were the earlier implants in, what revisional procedures were performed, were there complications, etc. - before recommending the best approach for you.
You may want to consider more advanced alternatives, such as placement of Strattice, or even implant removal...
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Hello Beth and thanks for asking about possible recurring capsular contracture and breast implant placement
It would be so great to know your current implant position- maybe come back and share that with me. I would hold off on the decision about where to place the next implant until I assessed the quality of the contracture, the quality of your skin, the volume of your breast tissue and the type of implant to be used for the replacement. As a woman surgeon, I like to discuss at the consultation the goal that each woman has for breast implant...
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Reducing capsular contracture with breast implants
Most plastic surgeons, as I, would agree that submuscular breast implants have a lower rate of capsular contracture. I use the submuscular or dual plane techniques as my methods of choice.
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Capsular Contracture
Placement of breast implants under the muscle has the lowest rate of capsular contracture. So, if you have subglandular implants, it is best to convert to submuscular placement if you development capsular contracture. Newer evidence shows that placement of Acellular products such as Alloderm can help decrease contracture rate.
Good Luck.
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Capsular Contracture
Placing breast implants below the chest wall muscles has been shown to reduce the incidence of capsular contracture (hardening of the breast).In cases of recurrent capsular contracture, sewing in a piece of acellular matrix (such as strattice) can also help to reduce the contracture from coming back again.
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Location of implant
The choice of submuscular and subglandular is based on the patients anatomy, lifestyle, and understanding the pros and cons of each. The most common approach is submuscular. There is evidence that the rate of capsular contracture is less. I would not say the subglandular should never be done as has been posted here. If you have recurrent capsule problems from subglandular, I would suggest changing to submuscular, and possibly including acellular matrix.
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Capsular Contracture is common after breast implant surgery
The most common problem after breast implant surgery is capsular contracture. Our bodies recognize the breast implants as a foreign object and try to protect us from this "invader" by walling it off with a scar tissue like substance. This happens 100% of the time, but in only 10-20% of the time does it become noticeable by squeezing the implant causing shape distortion, firmness and even pain. If it deforms the breast severely and there is pain then surgical intervention is...
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Implant position and capsule contracture
Under the muscle is generally better to decrease capsule contracture. But in cases of recurrent capsule formation an acellular dermal matrix may be required. Donald R. Nunn MD Atlanta Plastic Surgeon.
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Preventing Repear Capsular Contracture
There is no reason for any surgeon to be placing implants over the muscle or in the subglandular position. Multiple studies have illustrated that the rate of capsular contracture is significantly higher when the implants are placed in the subglandular position. I also believe results are aesthetically improved with subpectoral placement. In addition there is no difference in the rate of capsular contracture between saline and silicone implants when placed in the...
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Capsular contracture and implant placement
Capsular contracture is less likely to occur when the implants are placed under the muscle, but it is important to exchange the old implant and remove the capsule.
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Decreasing the risk of a repeat capsular contacture
It sound like you had a problem with capsular contracture. Statistically there is evidence that shows a decreased risk of capsular contracture when the implant is placed under the muscle. If your original surgery had the implant placed in the subglandular position then the obvious plan would be to switch to a new pocket in addition to other proven methods to reduce the incidence of this problem. These would include preventing the implant from touching your skin, lint from...
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Capsular Contracture Recurrence
According to existing research, placent of implants under the muscle does significantly reduce capsular contracture rates. Saline less than silicone gel. however, contracture can occur under the muscle and with saline implants, but rarely. Other factors such as blood and bacteria may play a role as well. Where were your implants placed and what type of implants? Changing the location and type may certainly help decrease a recurrence along with a capsulectomy...
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Avoiding repeat capsular contracture
Unfortunately, there is no gauranteed procedure to prevent a repeat encapsulation. If it is mild, then a partial capsulectomy may work. The preferred procedure is usually to perform a complete capsulectomy and place new implants in a new pocket. Transitioning from a subglandular pocket to a sub-muscular pocket is commonly done. Conversly, transitioning from a submuscular pocket to a subglandular pocket is also done. No studies have ever shown definitively what...
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Submuscular vs. subglandular breast implants after capsular contracture
Capsular contracture can be caused by a number of factors, including hematoma, infection, or contamination of the implant at the time of surgery. Tight capsules are beast removed in their entirety. For recurrent cases it is often useful to place a small graft of biologic material over the implant. Whether or not the implant is over or under the muscle is determined by patient anatomy and implant type: old generation and saline implants are best under the muscle in skinny people,...
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Avoid contracture - a 2nd time?
There are several options to treat and perhaps reduce the chance of a contracture returning after revision breast surgery. In general, going below the muscle helps to reduce the risks of contracture. Talk to your surgeon about the options available to you. Best wishes, Aldo.
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Above or Below Muscle?
There are various factors regarding how you want your breasts to look and feel, but if you and your doctor have a good, open line of communication, you shouldn’t need to go back and forth on your decision. A major factor that effects how breast implants look and feel is whether they're inserted over or under the chest (pectoral) muscle. I do submammary and submuscular implants, inserting the implants under the breast tissue and over the muscle through an incision in the breast fold. The...
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Implant placement after capsular contracture
In general, it is best to place your implants in a submuscular pocket after the development of capsular contracture. If your implants were already in a submuscular position, a new pocket under the muscle but above the old capsule may need to be made. Sometimes the use of an acellular dermis can also be helpful to prevent migration of the implant into the old pocket.
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Best Breast Implant Positioning to Prevent Encapsulation?
Best, if at all possible, to replace breast implants in the sub muscular (dual claim) position to help prevent recurrent encapsulation.
Best wishes.
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Avoiding capsular contracture in breast augmentation
In revision breast augmentation surgery for treatment of capsular contracture it is important to remove all of the capsular tissue if possible and then place the implant underneath the muscle. Sometimes a textured implant may be recommended in order to further decrease the chance of recurrent contractures.
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Breast Implants- Above or Below
If you have had capsular contracture in the past, most likely your surgeon will want to place your implants behind the chest muscle. Capsular contracture is rare to see these days, but it can happen. Be sure to follow your surgeons post operative instructions for your best result.
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