I Have PIP Implants, Ruptured Right & Capsule of Scar Tissue Around. Replacement Needs to Be Located in a Different Pocket?

My surgeon said since i have a rupture, he will need to remove the capsule of scar tissue as well as the implant (whats left of it) and then he will have to place the new implant behind the muscle. If anyone could explain as to why it has to go into a different pocket that would be appreciated .They are currently situated in front of the muscle and i was hoping they could go into the same space as i know its more painfull behind the muscle and i had a hemotoma with my first op :( Thanks Candice x

Doctor Answers 4

I Have PIP Implants, Ruptured Right & Capsule of Scar Tissue Around. Replacement Needs to Be Located in a Different Pocket?

I think the plan sounds reasonable, but this could only be determined with an exam and knowing more about the case. Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Implant pocket position

In general, I prefer submuscular implants to provide more soft tissue coverage in the upper pole, and those that are placed submuscular are thought to have a lower risk of capsular contractures.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

PIP Implant Rupture

First, I'm so sorry you have to deal with this.  Fortunately, from a health perspective it looks like there are not any increased risks of health issues. 

The implants should be placed under the pectoralis muscles to reduce the rate of capsular contracture.  You are almost assured to get capsular contracture when the implants are placed over the muscles.  When placed under the muscles that rate goes down to about 5%.  It's a better operation for the long term.  In addition the pectoralis muscles give more coverage and hence camouflage to the implant.  This helps reduce the upper pole rippling that used to be so common with subglandular implants.    

PIP implants

I would go with the advice of your PS, without an exam its hard to say for certain but in general implants are positioned behind the muscle to help with scar formation and capsular contracture.  PIP implants need the capsule examined by a pathologist as well.  Your PS should be able to explain their reasoning so I would just ask them.  All the best, Dr. K

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