Recovery After Implant Exchange/mastoplexy

I've scheduled surgery for 07/08, & will be exchanging old 450cc saline for silicone, mod+ profile, under muscle, w/ full lift. One PS I went to said I'd need to be in a reclining position 50 min out of every hour for 2 wks post surgery to keep the lower part of the areola from changing shape, etc. Is this extreme? Also, I want to go smaller but not too small. Will the lift, combined with going subpectoral, and silicone change the illusion of size? Too much projection now so thinking 375-400cc.

Doctor Answers (9)

Reclining Position Recommendation after Implant exchange

+1

Each surgeon bases his recommendations based on his experience. That being said in my practice I usually recommend sleeping with your back elevated for the first week then any position. Speak with your surgeon and follow his advice is probably the best recommendation.


Orange County Plastic Surgeon
5.0 out of 5 stars 48 reviews

Implant Size for Revisionary Breast Surgery

+1

Thank you for the question.

I personally think you're taking too much responsibility in trying to determine the exact implant size prior to surgery.

Communication with your surgeon will be crucial to help you achieve your goals.  I find the use of goal pictures to be very helpful.   I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.


I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 


I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Implant exchange with a breast lift

+1

Exchanging your implants from saline to silicone with have a slight difference in appearance, but moreso in the feel.  Changing the position of the implants to a subpectoral will have an effect on your post-op recovery as it is generally more painful. The breast lift should help with redistributing you breast tissue over the new implant and prevent any shape problems with the exchange.

Asaad H. Samra, MD
New Jersey Plastic Surgeon
5.0 out of 5 stars 23 reviews

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Breast Implant Revision

+1

Fifty to seventy five ccs is not a significant reduction in size. The only way you may appear to have a real reduction in size is by going from pre to post muscular placement with this amount of actual size reduction. This may not even give you what you want. You need to discuss your desires thoroughly with your surgeon. As for surgeon, I would personally run from the one who suggested that you recline for most of 2 weeks. This is absolutely absurd. There is no data whatsoever to support this contention, and a lot to say it is ridiculous. This is also somewhat dangerous, as it can increase your risk of developing blood clots in your legs that have the potential of causing death.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast lift mastopexy implant exchange

+1

Since each breast is only made up of only two components,volume and envelope, and since you are having an implant exchange (volume) and mastopexy (envelope adjustment),  you should be able to go to any size you choose (consistent with your body type) and still have nice looking breasts.  If your volume now is too large, count on losing a bra cup size for every 200cc smaller you go.   Once the volume is set (under the muscle is safest) the skin is tailored to the correct contour.

 

As far as post op care is concerned: wear a comfortable front closing jogging bra except when bathing (shower only for the first 10 days) and do whatever feels comfortable.  Minimize chest exercise and bouncing for 4 weeks.

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 13 reviews

Implant exchange and lift

+1

Replacing your implants to go only 50 cc's smaller is not a big difference. Placing them under the muscle will be a bit more uncomfortable.  Inever heard to be in a reclining position. I do not think that will do anything.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Post-op recovery after implant exchange and breast lift

+1

When breast implants are being exchanged from over the muscle to under, you will have to avoid vigorous physical activity for a while because of the surgery around the muscle. The breast lift (mastopexy) adds a layer of complexity but not necessarily additional recovery time. Good support is needed during the healing phase. The recommendation for reclining is not one that I have heard of but I do recommend that you follow your own surgeon's advice.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 28 reviews

Recovery switching to sub-muscular breast imlpants

+1

Ordinarily implant replacement or exchange is fairly easy as the pocket is already established and the hard work behind. Switching to a sub-muscular pocket will involve a week of recovery, just like those who will be having implants for the first time. The reclining bit makes no sense and a being up and about  in a good support bra should suffice.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 30 reviews

Recovery after implant exchange

+1

If you are going from above the muscle to below, you will have the majority of your discomfort from releasing and making a pocket under your muscle.  I have not heard of having a patient spend most of their time reclining to avoid a change in the shape of their areola after surgery.  As long as my patients wear the good support bra we pick for them, they can be up and around as much as they would like, but no bouncing for 6 weeks.  Saline implants tend to be rounder and project more than an equivalent silicone gel implant which has a more natural shape.  by going to a gel implant AND moving under the muscle, you will have a more natural contour and therefore less obvious implant edges being visible, but also less projection in general.  Going down 50-75cc in size will be noticeable (25cc is barely, 50cc just, 75cc more noticeable), but not that extreme...375-400cc are still good sized implants, though all of this is influenced by your anatomy, tissue thickness, etc.  The lift should not change your size, just where it is distributed.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 71 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.