Can Implants That Have Been Placed over the Muscle Be Replaced Behing the Muscle?

A so-called pocket exchange, refers to replacing implants from on top of the pectoralis major muscle to below the muscle, or vice versa. Two common indications for a pocket exchange from above to below the muscle are rippling  and capsular contracture, both of which are less common with below the muscle implant placement. This is generally not a difficult procedure, however, pocket adjustments are often necessary; specifically, the initial above-the-muscle pocket often has to be closed off or made smaller with sutures. Additionally, implants may feel and look smaller under the muscle, so a larger implant may be necessary if you wish to maintain the same volume. All of these issues should be discussed in detail with your surgeon, and you should make sure that any prospective surgeons you interview are experienced with revision breast surgery. Thanks for your question. Feel free to email any further questions.

Yes, you can definitely change implant position to under the muscle. This is commonly refereed to as a site change. Placing the implants under the muscle will ultimately give more tissue coverage and less rippling. However, note that when the implants are put under the muscle they are never completely under the muscle. The larger the implant the less muscle will actually cover the implant. The upper portion of and implant is covered with muscle and the lower portion generally is not. Also, if you have saline implants changing to silicone will help the look and feel of the implant. Good luck.

Certainly  implants can be replaced in a different pocket and very commonly done under the muscle in patients with thin soft tissue coverage.

Implants placed behind the muscle have better coverage so they typically show less rippling than sublandular implants.  Also, submuscular position of implants have a lower risk of capsular contracture.  Change of pocket from subglandular to submuscular can be performed but, it has its inherant risks that must be discussed with the patient. 

Breast implant revision surgery is often about "site change", i.e. the change in placement of the breast implant from in front of the pec to behind the pec muscle.

A plastic surgeon experienced in revision surgery will be able to give you options as to what may be best in your particular case.

Women who have particularly thin breast also benefit from increasing the breast tissue thickness over the implant with fat transfer.

Technically, yes implants can be moved from one area to the next. However, without seeing your pictures I can't say whether or not you would need a lift additionally.  

Yes you can have your implants moved to a partially under the muscle position. Doing this will provide more coverage of the implant and yield a more natural result. A plastic surgeon would need to examine you and then review your options with you of course. I would recommend reviewing the websites of potential plastic surgeons to see patients similar to you and the results they obtained.

I hope this helps.

Dr Edwards

Thank you for the question.

Often, it is possible to remove implants from the sub glandular position and place them in the sub muscular position. This procedure may serve to increase tissue coverage of the breast implants and may help with rippling/palpability of the breast implants.

It is important to evaluate the quality and the position of the overlying breast tissue/skin when making the determination  to exchange breast implant positions. Sometimes, breast lifting ( tightening of the breast skin envelope)  may be necessary when breast implant position  is changed.

I would suggest in person consultation with well experienced plastic surgeons.

Best wishes.

It is not an uncommon surgery to convert the implants from a subglandular pocket to a submuscular one.  This should help with disguising the implants and make them less noticable.  The recovery should not be as extensive as the first operation either.

I agree with you that your result will likely be improved by moving your implants to a submuscular position.  I place almost all of my implants below the muscle and I feel that this especially desirable in thin patients such as you describe yourself.  This will not guarantee a good result but will increase your odds.