Submuscular to subglandular breast augmentation revision. Increase to 700cc implants

Question

I have 485 cc (right) and 520 cc (left) implants placed below the muscle. I am currently weighing the pros/cons of switching to subglandular placement. I personally don’t like the animation caused from submuscular and I am very active/enjoy working out. However, I am apprehensive about the potential rippling or implant visibility that can happen with subglandular. I am also opting to go larger for my revision surgery. Any additional insight would be very helpful for the decision thank u!

Gianfranco Frojo, MD · Answer

Without photos or an exam, this is a challenging question to answer. I recommend seeing a board-certified plastic surgeon (American Board of Plastic Surgery). Ideally, this surgeon has also completed an accredited aesthetic fellowship (The Aesthetic Society).

Daniel Barrett, MD · Answer

Dear Plucky948075,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size. However, 700 cc implants weigh 1 1/2 lbs. each. The weight of the implants will stretch out the skin in front of the muscle. When placed underneath the muscle, the implants can extrude inferiorly and laterally. If you are satisfied with the position of your implants now, you may want to consider fat transfers as an alternative rather than enlargement. The fat transfers can be performed to create upper pole fullness or more medial placement, depending on your desires.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Without photos there can be no specific recommendation for you, but I can tell you that your animation deformity is most likely due to either a mismatch of anatomy and implant dimensions or the potential need for a breast lift that was instead addressed by having your inframammary fold lowered unstead, or both. Changing pockets and going bigger will not only increase your risk of rippling, but also capsular contracture. If you want a specific recommendation for you, you'll need to post photos of your before and current, or better yet, go on some in person or virtual consultations.

Connie Hiers, MD, FACS · Answer

I do not recommend going up to 700 cc's, especially if you want them sub glandular. At that size, they will just stretch your own tissue and sag. I would suggest going smaller to decrease the sag potential. For long term, submuscular is still best. It helps support the weight of the implant and hides it nicely.

Darryl J. Blinski, MD · Answer

Since you won over inflated implants in the 700 cc range, I would recommend changing the sub muscular to the dual plane or sub glandular position with some subdermal facing to try and avoid rippling affect of implants. Best virtual consult with expected to be in the $10,000 range.

Mats Hagstrom, MD (license on probation) · Answer

Dynamic aspect of sub muscular augmentation is probably not the best reason to have the revision surgery you have outlined.
You only get so many shots of doing this procedure and once you start moving things around you’re setting yourself up for eventual breast implant failure.
Using excessively large implants always increases the chance of undesirable side effects, increased complication rates, and will definitely need for revision surgery.
The best breast surgeons typically use sub muscular placement because of the many advantages.
Switching to sub glandular wall at the same time going much larger with your implant is a set up for future problems.
Without even including before, and after pictures, we can’t even begin to make an assessment.
What you describe does not sound like a solid game plan. 
Best,
Mats Hagstrom MD

Submuscular to subglandular breast augmentation revision. Increase to 700cc implants

Answers (7)

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