Best Fix for 10-year Old 500cc Overs?

In 2002 I had 500cc saline implants placed over muscle and now there is considerable rippling and ptosis. One surgeon I consulted with suggested a lift and moving to silicone under pec, actually going to 600cc to retain volume. Another suggests unders, silicone, using collagen sheets and smallest implant I am comfortable with to prevent bottoming out (he says my skin is very thin). I am a competitive bodybuilder as well. Main goals are to get rid of the sagging and rippling; best way to proceed?

Doctor Answers 4

Large saline implants in a thin patient with rippling

What you describe is a difficult situation.  My best advice to you would be to seek out an experienced surgeon who can go over your options, and MOST IMPORTANTLY, who has performed a large number of cases like yours.  If your surgeon does not have before and afters of the operation he is recommending that look acceptable to you - find another surgeon!  I have had the best outcomes in your situation by deflating your saline implants and allowing that pocket to close down before undertaking the lift and exchange to under the muscle with gel implants.

Henderson Plastic Surgeon
4.9 out of 5 stars 299 reviews

Exchanging implants in a body builder

Most likely your implants are above the muscle because your surgeon did not want to violate the pecs in a competative body builder.  Your best option is under the muscle with gel implnats.  It will effect the pecs.  I can't comment on the lift without a picture.

Talmage Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

Thin Tissue, Rippling, and Ptosis with Subglandular Augmentation

           Both options could be technically performed.  The second, particularly the downsizing of the implant, is the safer of the two, but the first is an attempt to allow you to have the volume you may desire. If your rippling is an an area that would be covered by the pec, then you may not need a dermal matrix.  However, if the rippling is inferior or lateral to the pectoralis, then the matrix option is a better, albeit more expensive, option.  Fat grafting can be used in rippling situations as well, and I have used all of these things.  Also consider that as a bodybuilder the strength on any chest exercises will be reduced some, and that the muscle will be more visible when it contracts.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

500 cc implants over the muscle

Both options sounds reasonable, but without an exam I can not offer more thoughts. I usually place implants under the muscle in thin patients.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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