Going from Unders to Overs to Correct Implant Displacement?

My implant is being forced down by muscle combined with tissue being too soft and not holding it up in position. Im 4mths Po from 300 unders.ps says that stitching the pocket up may not resolve issue as muscle is strong and may just keep happening,require further surgeries.im Concerned as was told I don't have enough breast tissue to have overs previously.Ps has suggested 310cmh 100% fill to avoid rippling,will implant be too visible and stuck on looking?5'6" 9st8,32a thanks

Doctor Answers 2

Correction of Breast Implant Malposition Problem?

Thank you for the question.

As you can imagine, it is not possible to give you precise advice online (despite your thorough description of your situation).  However, generally speaking, I prefer the use of Internal suture repair ( capsulorraphy)  for correction of implant malposition  problems as opposed to exchanging the breast implant positioning ( and potentially exposing you to the problems associated with sub glandular breast implants,  that you are aware of).  Although there is a recurrence rate of implant displacement/malposition  associated with capsulorrhaphy surgery;  I have found that this displacement recurrence rate is very acceptable after experienced repair of the breast implant pocket and careful limitation of patient activity after surgery.

 In other words, I think you have some very valid concerns and should potentially consider additional in person consultations. These additional consultations may serve to provide you with additional options.  Eventually, after obtaining more information, you will likely feel comfortable with the surgeon and the surgical procedure you choose.   During this process, ask to see lots of examples of the plastic surgeons' work.

 You may find the attached link helpful as well.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Going from Unders to Overs to Correct Implant Displacement

During breast implant surgery a #pocket is created carefully to maintain certain folds on the sides and bottom of the breast. Occasionally, the space for the breast implant becomes too large on the #side of the chest or the tissue stretches and the implants fall too much to the side. This is most easily seen when the patient is lying on her back. At times, the implants can move towards the patient’s armpit.

Treatment will generally require closing the space with a procedure called a #capsulorrhaphy. In this case, the capsule is closed off internally much as we do when we are trying to raise the breast fold. The capsule is closed with sutures and at times Acellular Dermis Matrix (#ADM) or other soft tissue substitutes would be used to further support this correction.  An in person exam with your Plastic Surgeon will better determine if this is the case.

There are some studies that report a lesser incidence of firm capsules with placement behind the pectoralis muscle. If you developed firm capsules and your implants were submammary (behind the breast tissue) then conversion to a #submuscular position should be considered. This #placement is particularly better for the very thin patient who has little breast or fat in the upper part of their chest. In most circumstances, those patients with #ptosis (#sagging) require placement above the muscle in a #submammary position or under the muscle combined with a mastopexy (breast lift) for #contour purposes. It's best to consult with a board certified plastic surgeon in person to learn your options. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.