Augmentation revision? I have 350 mentor saline, submuscular.(Photo)

Need advice have 350 mentor saline submuscular I want larger implants and lift with nipple reduction Problem is .... the implants have stretched my muscles because when I lie down they fall to the side significantly should I get them placed sub q to let muscles heal? Also can I get the lift I want with just peri aereola incision I want the to point up a bit thanks in advance

Doctor Answers (9)

Augmentation revision? I have 350 mentor saline, submuscular.

+2
Appears as if left is ruptured or deflated??? Best to seek immediate examination. Than use larger implants with a lifting operation... 


Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Breast aug revision

+2
Thank you for your pictures. I think it's okay for you to have larger implants placed and you probably will need a lollipop lift to achieve the look that you want. This is tough to determine from the picture so I suggest an in person consultation to get a solid treatment plan.

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

Augmentation revision? I have 350 mentor saline, submuscular.

+2
Hi and thank you for the question. You could very well have an implant exchange to a larger size. In order for then implant to affect the lack of fullness in your upper pole I would suggest that you consider at least a 500cc+. This will give you the fuller look on top. Do not have your implants changed to the subglandular position. Keep them behind the muscle. Th reason your implant may be displaced to the side when you lie down may be that the pocket which contains the implant is too wide and therefore the implant shifts to the side when laying down.

Your other option is to have a circumareolar (donut) breast lift. This entails a skin reduction around the areola thereby obtaining a small lift and reducing the diameter of the areola. IMHO this is not a great operation. The areola will frequently enlarge to it's original size and maybe bigger. In addition, the lift is not that significant and the breast lacks anterior projection. I will use it when a patient is very reluctant to have vertical scar ( lollipop) or traditional anchor type of incision.

Good luck on your journey.

Jose Perez-Gurri, MD
Miami Plastic Surgeon
5.0 out of 5 stars 48 reviews

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Lift? larger?

+2
You can certainly go larger if you like. Depending on the width of your new implants and how far your current pockets reach to the sides, you may or may not require a "capsulorraphy" - a repair to narrow the pocket from the inside.
As far as the lift goes, you can do a peri-areolar lift but it will tend to flatten your breast more and not lift as "high" as a vertical lift would offer. The best candidates for the lift around the areola are the patients who need a lift the least and have more cone shaped breasts.
I would absolutely recommend staying under the muscle.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 18 reviews

Breasts Uplift

+2
You need a breast uplift of the vertical type.   Leave the implants under the muscle and you will be better served.   Big implants cause big problems so be forewarned about this.    My Best,  Dr C

George Commons, MD
Palo Alto Plastic Surgeon
5.0 out of 5 stars 26 reviews

Revision surgery

+2
The questions involve mobility of the implants, size increase and lift.

As to the mobility, if large implants stretched your muscle, larger implants will easily stretch your breast skin, and in  that regard, you will be no better off. Large natural breasts fall off to the side as do implants. The use of textured shaped silicone gel implants are likely to result in less mobility of the implants.

Implant size is certainly your call.  There certainly appears to be enough capacity for larger implants. If you choose very large shaped gel implants, your surgeon may well recommend incision in the breast fold. 

As to the lift, an actual exam will be the only way to get a definitive answer.  Much will depend upon the amount of lift you see as a goal.  With the photo in which you elevate the nipple and areola, I suspect that you may be looking at a suggestion for a vertical lift. An incision around the areola alone will be a challenge to maintain a smaller size in the face of a larger implant.

Thanks for your question.  All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Revision augmentation mastopexy

+2
Hello and thank you for your question

revision breast surgery after primary augmentation can be a challenging and potentially risky situation.  

It is critically important that the surgeon who helped you with this problem is experienced in revision breast surgery. 

Based on your description it sounds like you have three main concerns

1.  Pockets that are wider than the implants

2.  Wanting to increase the size of the implants

3.  Lifting and reducing the nipple Areola  complex while minimizing overall scarring

depending on how wide your current pocket is by increasing the width of your implants you may both add size while minimizing the falling off to the sides that you're currently noticing when lying down.  The implants would simply fit more snuggly in the space available

this can be accomplished through a periareolar incision. 

Adding a periareolar mastopexy is also possible however limiting incisions around the nipple is critical to protecting blood supply of avoiding complications. 

For blood supply reasons I would also not choose to switch to an above the muscle pocket as this can risk nipple blood supply even more

if a pocket change is absolutely necessary I would ask your surgeon about using a neo-submuscular pocket which is a powerful new were technique they can achieve the same goal while protecting blood supply


Pranay Parikh, MD
Springfield Plastic Surgeon

Deflation of saline implants

+1
Based on your photographs it appears that your left implant was partially deflated.

Replacement of the deflated implant may solve your problem.  If needed a lift can be done.

For more information on combination breast lift and augmentation please read the following link:

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
4.5 out of 5 stars 29 reviews

Breast augmentation revision

+1
Your goal in pursuing a revision augmentation has several components. You want larger implants that don't fall to the side, a breast lift, and an areola reduction. Procedures to treat all of these at once need to be carefully put together for the best results.

1. Larger implants - The most common reason why women have another surgery is because they want a different size. An exchange to larger implants can be done - but should be carefully combined with the other procedures.

2. Implants that don't fall to the side - This is something that can happen when implants stretch out the breast tissue, and happens especially with implants that have a smooth surface because they move around more inside the breast. I would not recommend switching from the submuscular position to the subglandular position (a switch from under to over the muscle). This can make a combined breast lift more risky by decreasing the blood supply to the nipple. The procedure that helps implants to stay on the front of your chest (pointing forward even when lying down) would include tightening the implant pocket on the sides with tightening sutures in the implant capsule. We call this a capsulorrhapy, and sometimes it is strengthened
with the placement of a tissue matrix.

3. Breast lift - This is what will make your areola smaller and will move your nipples into a higher position. Your options for incisions would be a periareolar lift (where a donut shape of skin is removed) or a more traditional vertical lift (lollipop type incision) or more extended lift with an inverted T type of scar. Your plastic surgeon will be careful to balance the tightening effect of a lift, with the expanding effect of larger implants.

When I see a patient with all of these goals, I generally put it all together with a breast lift with a lollipop type incision (vertical breast lift), and a implant exchange with tightening of the implant capsule on the sides (lateral capsulorrhaphy) with support of the a tissue matrix on the sides. There are many choices for tissue matrix support including Strattice, Seri Scaffold and Tigr Matrix..

Kamakshi Zeidler, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 4 reviews

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.