Can an AICD/pacemaker AND a saline breast implant both be placed submuscular?

Yes, however, the most important element is to have the generator and wires properly placed to have adequate current and direction through the heart to be able to defibrillate reliably.  This is tested during the placement of the defibrillator.  Also, the generator and wires need to be placed such that neither of them will move later.  Sometimes this can be accomplished by using separately dissected pockets, with the generator box placed higher up on the chest, perhaps accessed through the axilla, and the implant placed into a separate pocket through the inframammary fold.  Even the newer low profile generator boxes however do have some bulk, so expect that there will be some asymmetry between the two sides.  AICD placement is generally done in an electrophysiology lab in a hospital, so good coordination is essential between the cardiologist and the plastic surgeon.  Good luck!Any information in the publications, messages, postings, articles, online courses on the website should not be considered a substitute for consultation with a board-certified plastic surgeon to address individual medical needs. Your particular facts and circumstances will determine the plastic surgery treatment which is most appropriate for you.