Possible to Replace over Muscle Implants with Under Muscle Implants?

You situation is very complicated and you definitely need to be see by a board certified plastic surgeon that has experience in breast revision work. Having said that, you have been behind the muscle and now are infront and want to go back under. Easier said than done. It is not a technically difficult task but anatomically it may not be possible.

The muscle has probably window shaded up wards and you will likely not get any coverage of the implant any more. So really you are still going to be subglandular or in front. Once you go under the muscle and then go in front you are pretty much committed. This is very unusual, because in most circumstances implants are taken from a subglandular position (meaning in front) and then are put behind. This is possible and works well.

It is often possible to replace your sub glandular implants back to a sub muscular pocket.  The muscle will have to be raised back off the chest wall and attached to the undersurface of the breast with sutures to close off the sub glandular pocket so the implant will remain in the sub muscular plane.  This sounds easy but is not always possible if the muscle has retracted or atrophied or there is extensive scarring.  

There should be no problem repositioning your implant from over the muscle to submuscular (under the muscle). We frequently perform this type of surgery.

Breast implant pocket position is changed often.  I perfer under the muscle since the look more natural, in my opnion. This change shnould not be a problem

After multiple planes and surgeries there is only one technique that will deliver a beautiful shape and lasting result in my opinion, subfascial placement.  I commonly use a technique called 'cold-subfascial placement' to correct undesirable results of multiply operated breasts with beautiful results.  this technique allows the use of strong structural tissue in your body to create an internal brassiere to hold and shape the implant in a tear drop form.  It also gives relative protection to the breast tissue and skin from stretching and gravity.  I hope this helps!

 

All the best,

 

Rian A. Maercks M.D.

When your implants were moved above your muscle, the prior submuscular pocket has problly scarred down and the muscle length has probably shortened.  You have heard right, it many not be possible to back under the muscle and the muscle coverage alone may be very inadequate. 

This is unfortunately a problem we are seeing more often as the era of breast implants extends. Yes, it would be possible to transpose the implant back under the muscle however it may be challenging to elevate this plane and the muscle likely will be thin. There are porducts available that could help reinforce that submuscular plane that are commonly used in breast reconstruction that are acellular dermal matrices. That may be indicated in your procedure, but they are expensive.

Now that both spaces have been created the anatomy of teh breast has been altered significantly. Understanding what you are trying to achieve is going to be the most important aspect of successful surgery.if you are thin and the implant is visible through the upper pole skin going to a submuscular position will help if your pectoralis muscle can be mobilized.
A new technique which uses dermis to hold the pectoralis in place and support the implant and the lower pole of the breast is an excellent option in the right candidate.
You need to be evaluated by an experienced certified plastic surgeon to help understand what can be accomplished for you at this time.
Good luck

As the other doctors have pointed out, a lot can happen with the muscle inlcuding shortening after release. I have also seen it become very thin after an implant has been on top of it for awhile. You really don't know a lor until the actual time of surgery.
Every case is different, and as long as you have a good reason to have the exchange, you should be able to get good results from a qualified surgeon.

You can change the pocket location of your implants. However, you need to be examined, and have your history reviewed before making a decision. I can't help but wonder why you initially changed the position from behind the muscle to in front.
Without clearly understanding your goals, it's hard to advise you and there may be an argument for leaving well enough alone!