I'm having my over the muscle saline implants replaced with under the musle silicone. The doctor has recommended a staged approach of removing the implants and then waiting 4 months to do the reaugmentation. I don't see a lot of information on "staging" so I'm interested to know is this common?
"Staging" a Reaugmentation?
Doctor Answers (11)
Few Reasons to do an implant removal first, wait and later put new implants under the muscle
Staging is usually done in conditions of possible pocket infection of or factors preventing breast implant removal and exchange for a deeper pocket.
The vast majority of Plastic surgeons, barring other circumstances, would remove the old implants and put in new ones in the same operation.
Staging breast augmentation
While it is certainly ok to stage the removal of implants and then reinserting new ones, I am always inclined to do it in one setting. I do not see the specific advantages of staging it versus just exchanging them.
There are some surgeons who prefer to do this as a staged procedure, but in reality, there are very few true contraindications to having it done all at once. There is nothing wrong with staging it, but it submits you to another operation, anesthesia, trauma, etc. In my experience, patients do quite well with the single - stage change from subglandular to submuscular placement. I hope this helps.
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"Staging" a reaugmentation
There must be a reason for "staging" the operation. I have done this a few times but the issue is the appearance now that determines the choice of operation. Like a severe asymmetric capsular fibrosis? Please advise of the reason.
From MIAMI Dr. B
Going from over to under and saline to silicone: changing the location and type of breast implant
It is hard to second guess another surgeon without an examination. This is a "safe" or conservative approach that is a reasonable alternative and may be recommended if there is concerns with the status of the muscle and the ability to close the pocket . By performing a staged procedure the original pocket will close on its own and not be an issue at the second operation. If it is done in one stage, the muscle will have to be sewn to the gland. This is not quite as easy as it sounds and may be the reason your surgeon prefers two operations.
Removal/Replacement of Breast Implants
I would not be inclined to "stage" your procedure unless there were extenuating circumstances about which I am unaware. I feel that is safe to perform the procedure moving the implants from subglandular to submuscular locations in a single stage and it is certainly more economical to do so.
Secondary breast augmentation and staging
This is a reasonable approach. I certainly prefer doing this type of procedure staged, but it is not unreasonable to do it in one stage ( I just did the procedure in one stage 11 days ago, tear drop shaped overs, to under the muscle round smooth saline).
Staged tends to be safer and more predictable. There will always also be a chance that you may need a lift depending on your exam.
Two stage submuscular breast implant conversion
There might be some circumstances in which I could imagine suggesting this but they are few. Most all the time a submuscular breast implant conversion is done as a single staged procedure. Certainly, a 2 staged one would work but it exposes you to 2 surgeries, 2 anesthetics and 2 recoveries probably unnecessarily.
Staging redo augmentation
Because of the propensity for the implant to find its way back to the old pocket, some doctors feels it is more reliable to remove the implant and allow the old pocket to obliterate and then start again. Eachcase and each surgeon is different is assessing this risk.
One stage is the most common for over to under breast implants
I am sure your surgeon has good reasons for recommending the staged approach but it isn't the most common. There are a lot of variables so none of us who haven't seen you can say for sure what the reasons might be in your case. Since the muscle only covers the upper half of the implant, perhaps your surgeon is trying to improve coverage for the lower half, which could also be achieved with a graft called Strattice but that would add to the cost (possibly offset by the anesthesia fees and other costs of having 2 surgeries.) Might be worth looking into: www.renewingyou.com
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.
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