Should I Go Back to Overs Because I Do Not Like the Unders?

I had 475cc saline overs for 13 years with no issues. After having a child I had a lift with 475cc silicone implants put under the muscle. I have worked out for many years and extremely fit and toned. I find it extremely uncomfortable to work out with them. Also my muscle pushes them off to the side creating more side boob than cleavage. I am considering going back in to have them put back over the muscle. Any advice?

Doctor Answers 6

Switching to Over the Muscle Implants in Athletes

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   As a bodybuilder, I am keenly aware of these problems.  Based upon your description switching to above the muscle seems to correct surgery for you.  Find the board certified plastic surgeon with the best credentials to perform the surgery.

Implants on top of the muscle

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Sounds like you are having the classic issues with implants under the muscle.  It seems reasonable to place them over the muscle if you were very happy with them in that position. 

Dennis Dass, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 180 reviews

Should I Go Back to Overs Because I Do Not Like the Unders?

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This "animation," movement of the implants with arm motion, is one drawback of subpectoral implants. Your proposed solution sounds like a good one. The implants can be moved above the muscle, preferably under the original capsule and the fascia of the pectoralis.

Thanks for your question, all the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Should I Go Back to Over the muscle Because I Do Not Like the implants Unders?

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It is for this reaso that I prefer the subfascial placement of implants

The fascia is the lining of the muscle .It offers support without the abnormal muscle contraction seen with submuscular placement

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Under or over, which is the correct plane?

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Chrissy890: Great question.  Generally speaking, the majority of US based PS recommend "unders" for the following reasons: 1) greater amount of soft tissue, pectoralis major muscle to drape over an implant to camouflage the upper pole; 2) potentially, without working chest muscles, a more natural look; 3) possible decreased risk of capsular contracture; 4) improved ability to image the breast with mammograms; 5) offloads forces of gravity on the breast skin brassiere. Chat with your PS and discuss his/her rationale for changing the plane. At the end of the day, since you are physically fit and inconvenienced by the "lateralization" which occurs upon working your chest, you may be better served by repositioning the implants above. :)

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Switching from submuscular back to subglandular implants for implant displacement.

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You appear to have proposed a reasonable solution for your pectoralis muscle implant displacements (downward and outward).  In fit patients with well developed and exercised pectoralis muscles, displacement, as you described, is always a concern.

When you discuss, with your plastic surgeon, the subglandular surgical placement  of your implants, he (or she) should also evaluate whether there has been any significant ptosis.  Low breast positioning could compromise your result without a breast lift....

Best Regards,

Douglas J. Raskin, MD
Colorado Springs Plastic Surgeon
4.9 out of 5 stars 68 reviews

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