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Will a Revision Fix my High Implant Placement?

asked 1 year ago by Boston3771 in Boston, MA
Latest answer by Robert L. Kraft, MD
Question viewed 2,448 times
Tags: silicone implant, 550-599cc, high, high profile, results

I had surgery 4 months ago. The Dr. placed High profile 550cc silicone implants under the muscle using the axillary approach. My implants are so high up on my chest wall they are touching my clavicle bones.

I originally had 300cc saline implants over the muscle.The implants never dropped, I am considering having a revision done in June, using the periareolar approach . How high are the chances that my implants will remain high even after the revision?

21 answers to Will a Revision Fix my High Implant Placement?

Superior malposition of breast implants

I agree that your result is unacceptable. the good news is that superior malposition of implants is one of the easiest fixes for plastic surgeons who specialize in revisionary breast surgery. I agree with performing a periareolar approach and performing an inferior capsulotomy or partial capsulectomy. Your chances of success are very high.

Paul E. Chasan, MD
Del Mar Plastic Surgeon

www.drchasan.com

Implant revision

First perhaps your body can not accomodate for such a large implant. The other consideration is that the pocket was not dissected adequately from the transaxilary approach.

Steven Wallach, MD
Manhattan Plastic Surgeon

Implant Revision Answers

I agree that a revision is necessary at this point. It is unlikely that your implants will drop enough to be satisfactory after 4 months. A periareolar incision is appropriate as well. I do think that you would be better served with a lower profile implant. A Moderate Plus profile would give you a more natural look even after they are properly placed. HP profile tend to look very "torpedo like" even in the best situations for augmentations unless you... more

Leif Liu Rogers, MD
Beverly Hills Plastic Surgeon

Breast implants: too large and too high

Hello, Why were larger implants placed during your revision? Your current state of affairs appears to feature high placement of large implants without adequate soft tissue to allow descent. I would likely advise smaller implants, but can't be definitive without examining you first. Best Regards, John Di Saia MD see video

John P. Di Saia, MD
Orange Plastic Surgeon

Implant revision

I agree that the implants are too high. I think transaxillary approaches have a narrow "sweetspot" for getting ideal implant position because the space is created from above and outside the breast. I think a periareolar (or inframammary, for that matter) approach can help reposition implants by releasing the lower border of the scar capsule and possibly releasing breast tissue below the lower border of your pectoralis major muscle to let the implants sit lower in the breast skin... more

Tim Abou-Sayed, MD
Palm Beach Plastic Surgeon

Breast Augmentation Revision Requires Accurate Implant Position

The quality of outcome associated with primary breast augmentation and revision depend on several factors. Implant position is important. If adequate release of the muscle and or capsule was incomplete when the implants were placed under the muscle, the implants will sit too high. In addition, because you have a short nipple to fold distance, a large implant like these will likely give you too much superior pole fullness. Saline implants are heavier and tend to drop a... more

Glen Brooks, MD
Springfield Plastic Surgeon

Poor implant placement

A revision of your current implant position can be achieved. Using a periareolar approach will allow access to the space under your muscle much more easily allowing the implants to be lowered. It is also entirely possible that the wrong implant was chosen for your chest wall dimensions. If your anatomy does not allow a certain size, any approach will lead to a poor result. I would highly recommend considering a smaller implant.

Naveen Setty, MD
Plano Plastic Surgeon

High riding implants

I think revision using a periareolar approach would be helpful. I agree with the other comments that the implants seems a bit too big for you. Having said that, lowering the fold along with capsulectomy will allow the implant to drop and you may be able to keep the same implants.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Will a revision fix my breast augmentation?

The chances that a revision will lower your implants depends partially upon whether or not the original scar capsule was released/excised during your last revision, as well as whether or not the lower portion of the muscle was released. If they were not released, additional implant volume tends to go up toward the clavicle, and releasing them may help. You may also wish to confirm that the width of your current implants is appropriate for your frame – excess width also... more

Craig S. Rock, MD
Houston Plastic Surgeon

www.drcraigrock.com

Revision of Breast Augmentation Can Improve Misplaced Breast Implants

Dear Boston3771, It appears that your breast implants are both too high and too large. When placing breast implants through the armpit, I prefer to use an endoscopic techinque to ensure that I am able to release the lower border of the pectoralis muscle completely so that the implants do not sit too high. A revision breast augmentation performed by a skilled surgeon should be able to correct the malposition. I would consider choosing a smaller implant. I would also consider performing... more

Larry Fan, MD
San Francisco Plastic Surgeon

Breast Implant Revision

At six months after your last surgery, I would suggest releasing the lower aspect of your implant pocket on both sides - to lower the implants. The areolar approach would be most suitable for this. Also, your new implant volume seems disproportional for your frame. You may wish to re-consider a smaller size to end up with a more natural appearing result.

Stephan Baker, MD
Miami Plastic Surgeon

Breast augmentation revision

The implants that were placed are too big for your breast. You appear to have a fairly short distance from your infra-mammary fold to nipple - thus your breast will not accommodate a large diameter implant. Furthermore, the trans-axillary approach, when done by unskilled surgeons, can result in implant malposition if the muscle is not divided properly - this could be the case with you. I think your plan for a peri-areolar revision is sensible, but stick with a smaller implant that fits well... more

Scott Sattler, MD
Bellevue Plastic Surgeon

Will a Revision Fix my High Implant Placement?

Yes a revision can help attain a beauty result. Just have the inferior pocket dissected correctly. Obtain a few in person opinions.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Revision breast augmentation is usually successful.

Hi. You definitely need a skillful revision. The implants are too high, specially the left one. But the excessively large implant size is also contributing to the poor result. see video

George J. Beraka, MD
Manhattan Plastic Surgeon

Revision of your breast augmentation should give you good results.

Trans axillary sub muscular breast augmentation is an excellent approach and in the right patient gives great results in the hands of well trained experienced Plastic Surgeon. Unfortunately your implants are way to high which is not uncommon with this approach in inexperienced plastic surgeons. Your plan for revision through a peri areolar approach is a good idea. Unfortunately revising trans axillary implants that are too high is hard to impossible through the trans axillary... more

Carl W. "Rick" Lentz III, MD
Daytona Beach Plastic Surgeon

Revision of misplaced implants

The problem you have is that the implant pockets were not made low enough which is not uncommon with the axillary approach. The other is that the implant choice looks crazy on you. I would proceed with the revision and re-think the implant choice.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

www.randcosmeticsurgery.com

Augment revision

The transaxillary approach with inadequate dissection of the pocket can lead to the result indicated on your photos. I agree with others that the revision should be performed via another approach which should result in better placement on your chest. Without more information as to your weight and height, it is difficult to determine whether the implants are too large. Personally,I'd go smaller but it is unclear why you were not happy with the 300 cc implants. If it was the failure to... more

Robert L. Kraft, MD
New York Plastic Surgeon

Implant Too High

I would be optimistic that the position of your breast implants could be improved with surgery. Your implants are too high secondary to inadequate release of the pectoral muscle along the breast fold or from implants being too large. If the nipple to fold distance is short your implant may be too large. A good release of the muscle would be more effective from a inframammary incision or periareolar. I would prefer the inframammary approach as visualization is excellent. more

Richard Linderman, MD
Indianapolis Plastic Surgeon

Revisionary breast surgery

Much of the final “look” achieved after breast augmentation revisionary surgery depends on several factors: 1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal. 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Breast implant revision

Your implants will probably not settle any further after 4 months. Placing implants under the muscle through an axillary incision almost always look and stay too high. It is extremely difficult to place large silicone implants low enough in the submuscular pocket to look right...I don't even try. The submuscular pocket was not released enough along the breast crease. I would consider a revision through an inframamary approach to enlarge the pocket and release the... more

Stanley Castor, MD
Tampa Plastic Surgeon

Second revision, third procedure

Unfortunately poor choices and poorly done procedures lead to revisions and more problems. The first time around placing implants above the muscle is a poor choice and apparently they were of reasonable size but either were placed too high or healed in the wrong position too high. Technically the second procedure was a redo rather than a revision and a transaxillary approach is a poor one, particularly for redo procedures. The subpectoral pocket was not dissected out... more