Replacing submuscular implants placed over 10 years ago - Dual plane or subfascial? (Photos)

Question

Hello, I am 35 y.o. I had implants submuscular placed over 10 years ago. However they ride very high . Also, I dread the fact that there is not too much cleavage. Now, after having two kids one of my two breasts has more ptosis than the other , but I do not wish a lift since I develop keloids. What would you recommend ? Some doctors say subfascial ( to avoid muscle deformity , give more cleavage and since I’m weight lifting) others say dual plane . Do these also affect mammograms ? Thank you

Daniel Barrett, MD · Answer

Dear Nadia_,

I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Richard Baxter, MD · Answer

If you are a weight lifter then subfascial is better, but since you now have dual plane the muscle would need to be re-attached. The type of implant makes a difference with subfascial. Consider Motiva. However, if you are not experiencing any animation deformity or muscle weakness now then it may not be worth it.

Andrew Bonett, MD · Answer

Hi Nadia_, based on what you are describing and what I can tell from the photos, it is a difficult situation with a couple limiting factors. First, now that the nipple position is asymmetric, it is nearly impossible to attain symmetry without some form of a lift, even if just a small donut-type lift. Secondly, you desire more cleavage but currently have implants under the muscle which can push them away from center and make more cleavage difficult. Lastly, it seems that you are rather fit and don't have much fat elsewhere that would be available for fat transfer to the breast. Sometimes doing a little fat transfer just to the inner and upper breast can help with that last little bit of cleavage. I do agree with the opinion that a transition to subfascial would help improve cleavage and be less detrimental to your weightlifting. However, you need to be careful because the more you push the implants toward the middle, the more the nipple position can be displaced outward. Something has to give in this situation, and it is up to you and your surgeon to discuss these pros and cons and decided what meets most of your needs.

Connie Hiers, MD, FACS · Answer

I would suggest staying under the muscle, but go lower in profile.  The cleavage thing is related to your bony anatomy and it cannot be changed.  Keeping the implants behind the muscle gives a smoother contour, but separates the breast more. With a dual plan, more implant is visible, but breasts can sit a little bit closer..

Hilton Becker, MD · Answer

Subfascial  conversion will lower  the implants ,give more cleavage and eliminate animation deformity 
Dual plane will still cause animation

Replacing submuscular implants placed over 10 years ago - Dual plane or subfascial? (Photos)

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Answer: Replacing submuscular implants placed over 10 years ago - Dual plane or subfascial?

Answer: Replacing submuscular implants placed over 10 years ago - Dual plane or subfascial?

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Replacing submuscular implants placed over 10 years ago - Dual plane or subfascial? (Photos)

Answers (5)

Answer: Breasts

Answer: Breasts

Answer: Replacing submuscular implants placed over 10 years ago - Dual plane or subfascial?

Answer: Replacing submuscular implants placed over 10 years ago - Dual plane or subfascial?

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.