I'm no longer happy with how my saline implants look. I've had a baby since my BA in 2006, and breastfed so they are no longer looking good. One has a "knuckle" at the top by my armpit from it folding, and the other one has moved, so you can see the "port" through my skin on the side. I'm wondering how much it would cost to stay subglandular and switch to silicone? It seems like switching to a new submuscular pocket is very expensive. I want a natural look/feel. My implants are McGhan 68.
Switch to Silicone but Stay Subglandular?
Doctor Answers (10)
Avoid subglandular placement. Revising to a planned subfascial plane can deliver beautiful natural results
I would strongly recommend switching planes to a subfascial placement. Revising your breasts in the subglandular lpane is very unlikely to offer an aesthetically sound result and will certainly age quickly. Submuscular placement will certainly give you a strange look when you move your arms and will not offer any inferior pole support, where you need it most. The subfascial plane allows precise natural shaping of the breast with a strong support for the implant giving relative protection from bottoming out and gravity induced aging. This is why I developed the COLD-SUBFASCIAL augmentation. It allows the precise development of a breast shape that fits the patient's body and protects the valuable fascial tissue from mechanicaland heat damage assuring maximal fascial support. A large part of the cost is from the implants and O.R. fees. The revisional price should not sway your decision as a poor decision may lead to added surgical expenses in the future! I hope this helps!
All the best,
Rian A. Maercks M.D.
Recommend going submuscular
Because you are not happy with the present appearance of your breasts, I would not recommend changing implants and putting them back into the same pocket. I recommend putting your new implants into a new pocket which in your case would be submuscular. Consult a board certified plastic surgeon in your area. The cost should be about the same whether you put it back in the same pockets or into new submuscular pockets.
Remove and replacing and implants
Pregnancy and breastfeeding may affect the quality of your skin and cause it to thin. Removing your current saline implants and replacing them with silicone gel under the muscle may improve the appearance of your breasts and provide a more natural look and feel. Placing implants submuscularly can also prevent complications such as capsular contracture. Although, cost may be an issue for you, I recommend consulting a board certified plastic surgeon to discuss the best and safest possible option for you to avoid additional surgery and ensure the best results possible.
On this site, I do my best to give advice without a physical examination but I want you to know that a physical examination by a board certified physician is always the best way to get the most accurate information.
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Visible subglandular implants require a new pocket to correct the issue.
It is understandable to be concerned over cost when correcting issues with implants. However, if the goal of your surgery is to eliminate or reduce the appearance of implant folds in the upper pole, simply switching to silicone implants is unlikely to achieve this. In my practice, I do not charge more to site change the implants from subglandular to submuscular. Silicone implants are more expensive than saline, and if a lift is necessary due to breast ptosis, this too will add to the cost of surgery.
The bottom line is to correct the issues and provide long-term, attractive breasts. Addressing the issues at one time, as opposed to multiple operations over several years will save you time, money, and stress. Be sure to consult with a few Plastic Surgeons in your area to find out what will work best for you.
It appears that you are concerned about how your breasts look BUT also want the least expensive route for making them look better. Just be mindful that the last thing you want is to go through another procedure regardless of the "savings" and be dissatisfied.
The fact that your saline implant is so visible indicates that your tissues are very thin. Swapping to gel implant will make it better, but going submuscular will give you that extra layer of your own tissue to camouflage any waves, ripples of folds in the gel implant. You might also need a lift. See a board certified plastic surgeon and get 2 opinions.
Changing Saline to Silicone Breast Implants
Submuscular conversion of breast implants
You are describing that you are very thin. Consequently, even changing to gel but staying above the muscle, you won't have the best result for your body. Under the muscle the implants will look more natural, they will have less ripples and the long-term result will be much prettier.
Under muscle breast implant placement for more natural look
Revision Breast Augmentation
What you are describing sounds like rippling in saline implants. That is corrected either overfilling your saline implants, exchanging them for silicone, and/or placement under the muscle.
You also mentioned that your BA changed since you had a baby. After pregnancy/breast feeding breasts can sag and loose volume (become thinner) which may all contribute to your problems. You may also need a lift if you now have sagging.
Seeing pictures would be helpful. You should see a board certified Plastic Surgeon for a proper assessment. In terms of prices, I guess it varies from surgeon to surgeon and area to area, but whether you get a revision with subglandular or submuscular placement should have minimal if any effect on the surgical fee.
At our facility the fee is dependent on the type of implant you want and whether or not you need a lift. Whether the implant is above or below the muscle is not a factor.
Martin Jugenburg, MD