Breast Implants: Q&A

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Need to Switch Placement During Breast Implant Replacement?

I had silicone implants removed after 13 years and one had ruptured but the silicone was held in by the capsule formation. I replaced them with saline ones over the muscle and after 10 years one has ruptured. Is it time to go under the muscle? I am small with very little tissue but have feared cutting muscle and changing it for life. I am awaiting an appt with a plastic surgeon.

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12 Doctor Answers | Asked by anon

Doctor Answers (12)
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Need to switch implants

This is a difficult question to answer without seeing you, but you describe yourself as having very little tissue. I am surprised that you didn't have a great deal of rippling or wrinkling with saline over the muscle. I think you can do them either way with silicone. A ruptured saline implant should have no affect on the pocket although you may need a capsulotomy. If you were my patient unless you had a specific reason to go under the muscle, I would try to put them submuscular... more

Switching Implants

If you have a ruptured implants, then it is advised to have the implant removed and/or switched for new implants. In tertiary cases, it is also advisable to place the implants under the muscle to ensure that there is adequate tissue coverage of the implants. I hope this is helpful. Good luck with your procedure.

Over or under the muscle augmentation

The rupture issue has little to do with the placement of the implants. It is a risk intrinsic to the implants themselves. Whether you have the implants over or under the muscle is a very individual question that has many variable that you should review with your surgeon. There is no right answer. What you will need to do is prioritize the characteristics, side effects, and future risks of your surgery and breast augmentation and determine whether putting them over or under the muscle... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Need to Switch Placement During Breast Implant Replacement?

I generally prefer implants placed under the muscle especially in thin patients. I elieve this creates the most natrural looking breast.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Implants under the chest muscle

Hi there- It sounds like the only problems you have experienced in the past with your implants have been related to implant rupture- an inevitability that all women with implants should expect sooner or later... If you were otherwise pleased with the implants, there is no compelling reason to relocate them to a new pocket under your chest muscle- However... There can be no question that there are benefits to the patient of having the implants placed under the muscle. How great and relevant these more

Split muscle technique avoids cutting muscle with implants under

Although every case is different, in general I would recommend that the new implants go under the muscle. However, the traditional technique does require cutting the muscle off of it's attachment on the reibs which can cause things like animation deformities. Another option is the split muscle technique, which preserves all of the muscle attachments and function, but still allows the upper portion to go under where it is most helpful. It's one of the techniques used for athletic women who... more

Over or Under the Muscle the Third Time Around

The KEY to natural appearing augmented breasts is to get as much tissue as possible on top of the implants. Failure to do so ALWAYS results in the visibility and palpability of the implant shell and its folds. As a result, the Under the muscle position is better for most women but is absolutely ESSENTIAL in smaller women and women with little breast tissue. In your case, unless absolutely impossible, I would try and place your implants UNDER the muscle before looking anywhere else.... more

Switching pockets when switching implants

While I always go under the muscle for first time patients, if your implants were above the muscle and if there was no problem with capsular contracture, it is reasonable to stay above the muscle especially if your tissue coverage of the implant is adequate. Otherwise, it is best to convert to below the muscle.

No need to switch position of breast implants if they looked good.

Hi. If your saline breast implants over the muscle looked good for years, there is no reason to create new implant pockets under the muscle. Much more surgery.

Implant exchange and placement switch

If you are having problems with your implants that are above the muscle, such as from rippling or significant palpability, then you might conside going under the muscle.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Breast implant replacement

From your convoluted history, I can ONLY recommend an in person visit with a boarded plastic surgeon. This allows a physical examination to determine exactly the location for the implants. From MIAMI

Location Change with Implant Replacement

The determing factor in answering your question is whether or not you were happy with the appearance of your implants prior to rupture. If you were, there is no indication to change to another location. On the other hand, if you had wrinkling or a visible implant edge, then you should consider changing to a submuscular placement.