Is it possible to change the placement of my implants after they have been under the muscle, in the pocket that was created?

Ive had implants for 2 years. They are under the muscle. I feel they are too wide apart. No cleavage without a padded pushup bra. Im interested in a second surgery to correct this if possible. My surgeon says he wouldnt change anything. Im as self conscious now as I was before my surgery and I cant believe this is the only way my breasts can look. 

Doctor Answers 8

Can an implant be changed from behind the muscle to in front of the muscle?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Most definitely. I have done it many times for a number of reasons, and have changed them from in front of the muscle to behind the muscle as well through the years. I'm not sure it would solve your problem, however. If the muscle has not been dissected enough medially, then this would make the implants too far apart. If this is the case, when you flex the muscle the implant will distort and move laterally. Implants generally can be placed closer together when in front of the muscle. However, inplants may look better behind the muscle if a patient has very little breast tissue. I would suggest that you see a plastic surgeon who has changed the position of implants enough times to be comfortable with the procedure. A second opinion may help or may even substantiate what your PS has told you. Certainly, every effort should be made to make you happy with your implants if possible. This is an interesting problem. Thank you for the question.

Change position of implant and breast tissue

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Inadequate cleavage occurs for two reasons. One, the implants have displaced laterally and they need to be repositioned medial. Two, your implants were centered under the areola and your breast tissue needs to be moved medially. I recommend a new technique called The Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating more upper pole fullness, displace the breast medial to increase cleavage. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes cleavage. This can be done using the same implants or changing implants if needed. In the retro-pectoral position compression by the muscle determines projection, not implant profile.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Breast implant readjustments

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Dear chelle,

Breast implants can indeed be repositioned or readjusted.  Implant pocket adjustments can be made, different shape/size/volume implants can be used.  If you have made it clear to your American Board of Plastic Surgery board certified plastic surgeon that you are not happy with your current breast augmentation result and he/she is unaccepting of that fact, perhaps consultation with a second surgeon is in order.  Good luck!

Is it possible to change the placement of my implants after they have been under the muscle, in the pocket that was created?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Yes, using techniques that “adjust” the breast implant capsules (such as capsulorraphy), it is possible to adjust the positioning of breast implants on the patient's chest wall. Of course, whether this is indicated in your case will depend on your physical examination and specific goals. You may wish to submit pictures with your next post for more accurate advice. You may also find the attached link, dedicated to revisionary breast surgery, helpful to you. Best wishes.

Is it possible to change the placement of my implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Without pre and postop photos it would not be possible to comment on your specific question, but in general if your muscles are widely separated before surgery, the postop cleavage will be equally wide.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Breast implant revision for cleavage

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is very difficult to comment without photographs and/or an examination.  Each patient is built with unique anatomy and achieving cleavage in some patients is very difficult, if not impossible.  Moving the implants to a position over the muscle is possible and may allow you to get closer to your goal, but may be associated with other issues or complications.  One must always be careful in deciding to proceed with another operation and weigh the realistic potential benefits with its risks.  You should consider a second opinion with another board certified plastic surgeon to help you with your concerns. 

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.7 out of 5 stars 29 reviews

No cleavage after a breast augmentation - options for correction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
There are anatomical factors that keep the breast far apart in the midline.  With the implants under the muscle there will be limitations to the degree of cleavage you may achieve.  It is possible that a wider based implant may be used or a lateral capsule repair may need to be performed for you to achieve your results.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Wide gap

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Photos would be very helpful, especially the before photos.  As the implants are placed behind the muscle, the muscle itself dictates how close or far apart the implants will be after surgery.  One of the only ways to bring the gap closer together Is to place fat around the implants.

Edward J. Bednar, MD
Charlotte Plastic Surgeon
4.8 out of 5 stars 144 reviews

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.