Breast Implants: Q&A
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Replacing Breast Implants - Back Under or Go Over?
Last year I had 375 cc submuscular, then explant w/o replacement. I am 46.T oo large for my 5"3" 115 lb frame. I am thinking about getting implants again, but going smaller. My PS suggests over the muscle this time because I had pain and I would not have to worry about the double bubble. Under or over?
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9 Doctor Answers |
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5958anon
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Remove and Replace: Size and position
The double bubble issue depends on the breast tissue, the crease and the position of the nipple. You may require a lift as well. Under the muscle is likely to provide you with the most amount of tissue coverage and permit better quality mammograms. IF you go over, you may want to consider silicone to minimize rippling. Discuss these concerns with your surgeon.
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A smaller implant placed above the muscle may be the right approach
If I have interpreted your situation correctly you have had your original implants removed for two reasons. First they were too large for your taste and second there was a double bubble deformity. You are now considering replacing them. The second time around it will be easiest to correct the issue of size. Have your surgeon give you sizer implants to try on that are smaller then your original 375cc implants. This will give you a good idea of how much smaller you might want to go...
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"Buyer's Remorse" in Breast Augmentation surgery
All experienced Plastic surgeons see patients weekly who have chosen their breast implants poorly. Your choice of implants should NOT be based on what you read in women's magazines (starlet X got so many cc's, starlet Y just switched to so many cc's) nor on misleading and retouched Internet photos or compensated or phony testimonials, nor on phony "sales" or promotions by desperate doctors (often not even plastic surgeons), or on pressure from girlfriends and others....
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Replacing breast implants - back under or go over
Are you saying you had implantation last year than explantation within the same year, so two surgeries within a year? If yes, than I have a concern of your realistic expectations! You may be a risky patient and need a very detailed inform consent. As for replacement, I would recommend under the muscle again.
From MIAMI DR. B
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Implant position depends on your anatomy and reason for revision
Whether or not the implant is placed under or over the muscle depends on how thick your tissues are. If you are very thin, with visible ribs, etc. it is best to place the implant under the muscle. In these situations, the muscle will add thickness to the tissue coverage over the implant, and reduce the risk of visible implant edge. Other considerations do not apply to you. For example, if a patient is having removing and replacement for capsular contracture, I...
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Redo breast implants
An implant exchange can be performed if you want smaller breasts, but a thorough exam is critical to see what pocket, implant, etc., would be best for you.
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Replacing with smaller implants generally in the same space
If you didn't have a double bubble with the larger implants, you won't with the new ones in the same pocket under the muscle. The pocket itself may have to be adjusted, but that isn't usually very complicated to do. So if no problems other than size, keep it simple.
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Redoing augmentation requires retrospective analysis
The most important thing to consider in redoing your augmentation is why you had the implants removed in the first place. If size is the only concern then this is easy to fix but the issue of pain also needs to be considered as to why. Make sure to have a complete discussion with your surgeon about all of your prior symptoms and issues.
As thin as you are I would avoid putting implants above the muscle.
Best Wishes.
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Re-augmentation after implant removal
It is difficult to give you good advice without a photo or examining you. If you had a double bubble deformity with your first surgery it is possible you would benefit from a breast lift with or without augmentation. You also didn't say why you had your implants removed. I would return to your plastic surgeon and go over the details of why he/she recommended going over the muscle.
I wish you well.
Dr Edwards
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