Can I change my implants from subglandular to submuscular? (Photo)

Question

I currently have subglandular implants i am 4 months 335cc post op and have capsular contraction. I need a second surgery to fix it my surgeon insists in putting the implant subglandular and going bigger 415 cc. What should I do I am really concerned about it. I don't want another capsular contraction. He said something about my thorax.

Michelle Hardaway, MD · Answer

Your breast implants can be changed from a subglandular to submuscular position.  The capsule would be removed at the time of surgery.  You should get a second opinion from a board certified plastic surgeon in your area and discuss your concerns at the time of the consultation.

Michael E. Decherd, MD, FACS · Answer

There is less capsular contracture under the muscle.  I personally put all my implants either subperctoral or at least dual-plane III.  I would explore that route for sure.Good luck!

Daniel Barrett, MD · Answer

Dear mlz14,capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Michael Loffredo, MD · Answer

Yes changing the pocket from sunglandular to submuscular is a good option to treat capsular contracture

Amy S. Bekanich, MD · Answer

Hi - My recommendation to you is  to have new implants repositioned under the muscle and to have the existing capsules excised.  With already having one experience with capsular contracture I personally would want to do the best surgery to avoid having a recurrence.  I wish you all the best in deciding on your choices.
All the best - Dr. Bekanich

Bernard Kopchinski, MD, FACS · Answer

Thank you for your question. Another option I offer to my patients is Singular (allergy medication) that has been show to help resolve Capsular Contractures coupled with aggressive massage. Capsular contractures are more statistically common when implants are placed above the muscle. I personally place almost all of my implants sub-muscular. It is possible to move the implants sub-muscular. I would go over these concerns with your Board Certified Plastic Surgeon as they know your case best. Good Luck.

Jeffrey W. Hall, MD · Answer

Definitely, changing the implant pocket from subglandular to submuscular can be done. It is a very procedure to address capsular contracture and I have done this many times with success. Four months seems very quick to develop a contracture but subglandular implants are more likely for this to occur. If you have any reservations or questions about your situation it is always wise to get another opinion by a board certified plastic surgeon who has breast implant experience. Good Luck.

Suresh Koneru, MD · Answer

Yes, it is possible to change the position of your implants to the submuscular position.  It is difficult to tell from the photos exactly what needs to be done.  I would recommend seeking a second opinion with a Board Certified Plastic Surgeon and then sitting down with your first surgeon to review your options again.

William Rahal, MD · Answer

Pocket reassignment from the subglandular to submuscular pockets is definitely possible and it is also a very common procedure for treating capsular contracture.
I hope that answers your question on the two procedures. It's great you're doing your research. I always say that the best patients are informed patients.
Thanks for reading and best of luck on your journey!

Katerina M. Gallus, MD, FACS · Answer

Miz14 - your capsular contracture will certainly not be corrected by increasing the size of your implants, so I suggest that ask more questions regarding changing the size.  Capsular contracture can be corrected by creating a new pocket (neo-subglandular or submuscular) or removing the entire capsule and/or adding a dermal matrix scaffolding.  There are intra-operative techniques used to minimize the risk of post op capsular contracture and those should be explained by your surgeon as well.  This can include covering the nipples with a special dressing, antibiotic irrigation of the pocket and the use of a funnel to allow for a no-touch technique when placing the implant.

Can I change my implants from subglandular to submuscular? (Photo)

Answers (11)

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