Can I Get New Implants in the Same Above Muscle Plane?

I had my 35 year old silicon implants removed with a lift 4 months ago and I am very unhappy with the results.The left implant was rupture so the capsule was removed along with the implant.The right one was not ruptured so the surgeon removed only the top portion of the capsule. My question is can I get new implants put in the same above muscle plane?I realize that most surgeons like the unders better but I had mine for 35 years with no problems at all so I think that I should stick with overs.

Doctor Answers 8

Implant replacement above or below the muscle

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If there were no capsular contracture, it is okay to stay above the muscle.  Otherwise it is best to go under the next time.  Your description doesn't describe what you are unhappy with - it can be the implants or the lift.  If it is the lift, going under the muscle won't help.

Changing implants

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If you have adequate soft tissue coverage, you can possible have it done over the muscle, but under the muscle is believed to have a lower capsular contracture rate.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Replacing implants in the same plane

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Since you have already had two surgeries on your breasts, first the augmentation and then the implant removal with mastopexy, there is a lot of scar tissue that has been created, In addition, implant rupture may cause greater inflammation in the area. It is possible to have a secondary breast augmentation performed, and insertino of the second set of implants either above or below the muscle. You should discuss the procedure and your expectations with your surgeon before surgery, so you are not dissatisfied after this third operation.

Olivia Hutchinson, MD
New York Plastic Surgeon

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It is your body, so you decide!

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I agree with all the other answers. It is important for you to understand that in revision surgery, and specially on breast lift surgery, it takes time before you see the final result. I recommend you to wait at least 6-9 months before you make your final decision. Also it is important to be sure you see a BOard certified Plastic Surgeon (American Board of Plastic Surgery).

Good luck

Victor M. Perez, MD, FACS
Kansas City Plastic Surgeon
5.0 out of 5 stars 31 reviews

OVER OR UNDER when removing and replacing

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From your concerns, ti sounds as if your surgeon put them under the muscle but this is not clear in your desciription. Generally, most surgeons agree that there is a lower capsular contracture rate under the muscle and this may be the reason the surgeon was compelled to place them there.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

You SHOULD have the Breast Implants put where YOU want them ss long as You accept the Consequences

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There are a lot of reasons why breast implants should be put under the pectorals muscles and only a few why it should not. It is NOT the surgeon's responsibility to impose implant placement on you. I feel it is his responsibility to educate you on the risks of doing it either way and if he disagrees with your choice to refuse to operate on you rather than forcing you to have an operation you do not want to have. You have the right to make your own mistakes but neither you nor your surgeon should be forced into an operation they do not want to have or one that they do not want to do knowing the results would be suboptimal.

Peter A. Aldea, MD
Memphis Plastic Surgeon

New implants in the same above muscle plane

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Yes it can be done but the recommendation is to have under the muscle for better protection and results. Be careful out there. From MIAMI Dr. B

Breast implant position may affect cosmetic outcome

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There are several reasons most plastic surgeons prefer to place breast implants subpectoral (behind the muscle).  This is the best position to hide any rippling or wrinkling, especially in a patient with poor tissue coverage.  The muscle also tends to stabilize the implant over time so the weight of the implant does not cause additional breast ptosis (drooping). In your case, there may be some reluctance to replace your implants above the muscle since it is not a "fresh" plane and you may be more prone to capsular contracture.  In some patients the submammary (above the muscle) plane is preferable.  This would include woman who are fitness contestants or who do large amounts of pectoralis exercises as this may lead to implant visibility or displacement.  Certainly, if you have adequate amounts of breast tissue to cover the implant, and no significant previous capsular contracture, you may be a candidate for an implant above the muscle.  Seek the opinion of someone experienced in secondary breast implant surgery.

Glen Brooks, MD
Springfield Plastic Surgeon

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.