Once you've had implants done under the muscle, is it possibility to go over the muscle in a future revision?
Thank you for the question. Yes, it is possible to convert a “sub muscular” breast augmentation to a sub glandular augmentation, in most cases. However, generally speaking, there are many advantages to breast implants placed in the sub muscular position; therefore, this conversion should not be done unless absolutely necessary, in my opinion. Given that your operation was performed recently, I would suggest ongoing patience. If in the longer term, if you remain displeased, it is quite likely that with revisionary breast surgery that you will be able to achieve the “augmented” look without conversion of the breast implant pockets. Best wishes for a happy new year.
Can an implant be placed above the muscle if already below the muscle?
Thank you for your question. In short, yes, it is possible to place an implant above the muscle if it was previously below the muscle. There can be several reasons to do this but the negatives should not be ignored. Implants above the muscle tend to have more encapsulation or scar tissue formation. On the plus side, implants above the muscle tend to have more upper pole fullness as the muscle is not there pushing down on the top of the implant. An informed discussion with a plastic surgeon in person about the pros and cons is very helpful.
If you wish to be larger in the future, and your anatomy does not interfere with your goals, that can certainly be done. What I cannot tell is why you would considered changing the plane of the implants to above the muscle. Unless there is a pressing reason, you will probably be better off having the larger implants placed in the same pocket.
All the best.
Changing implant site
It is certainly acceptable to change sites implants. The risk must be balanced with the benefits of the procedure. Remember implants are not the end all and be all. They have certain limitations you cannot satisfy every breast shape, size, visual aesthetic and/or symmetry.
Breast Implant Pocket Change
One of the more common complaints following breast augmentation is "I didn't go big enough." You aren't alone in this complaint. However, it sounds as if you are happy with the results. Give it some time (at least 6 months) before you decide to "go bigger." If you decide you do want to have larger implants placed, spend some time with your plastic surgeon before your next operation and make sure you are on the same page as to size of implant to be placed. The fewer the operations under anesthesia, the better.
At the same time, realize that your plastic surgeon will be limited by your anatomy as to how large of an implant can be placed in your body safely. Staging this with progressively larger implants is safer than trying to put an implant in that may be more than your body can handle.
In regards to pocket/plane of implant placement, this can be done safely. But if you are happy with how things are (except for just wanting to be larger), I would recommend keeping the same pocket. Don't burn a bridge if you don't have to.
Good luck and I hope you get to the look you desire!
Above or below
Thank you for your question.
If you are happy with your results thats a good thing. If you think you want to be larger I agree with waiting until the son and breast tissue and muscle have had time to stretch and accommodate the size of the implant. A secondary procedure can be performed with larger implants. I would keep them under the muscle because there are advantages to this position. To answer your question though, the implants can be relatively easily moved from under the muscle to over the muscle.
Implants can easily be mover from submusculat to subglandular and vice versa.
There is no problem with the new location for implants. However, if you look natural and feel soft, think carefully before putting this excellent result at risk.
Progressive enlargement with breast augmentation is a better plan
I agree with my colleagues. I would not change the "plane" or "pocket" from under the muscle to over. I would relax and let the implants settle in place and allow the skin to adapt to the expansion of the breast implants you have now. Skin can only stretch so much with any one surgery and "extreme" expansions are often fraught with complications. It is not unusual for someone who wants to be very big to have to get there "in two steps". 6 months or more after the original implants have been placed, your plastic surgeon can go back and exchange the implants you have for larger ones - in the same pocket. It is actually better for your tissues to expand more progressively this way and the discomfort is also much less. I hope this helps!
Is it necessary?
Based on your description it is always possible to change the plane of the implant. But there are many reasons and advantages of placing under the muscle. Some of these are natural look, less obvious implant borders, lesser palpability and lesser mobility (implant don't fall laterally when you lay back in contrary to over muscle placement). Most common change in plane is from subglandular to submuscular. Ususally there are no apparent and strong indications for changing from submuscular to subglandular. Staying submuscular may only limit the distance between implants at the midline.
If you want a bigger implant with a better push-up effect or as you said augmented look changing the profile and size would do the job. For example if your implant is high profile it can be changed with ultrahigh (or extra full) projection. If your chest measurements are appropriate then the implant with a wider base can be used. But these details will confuse you.
In brief staying under the muscle is always preferred and the best option. The size can be increased.
Wish you good luck.
Implants below or above the muscle ?
If the implants are doing well under the muscle and you want to enlarge them simply stay in that plane ( sub-muscular) and just increase the implant size. There advantages to staying sub-muscular that you want to keep.
Stephen M. Davis, MD, FACS
Green Hills Plastic Surgery