Are Mentor smooth implants more prone to capsular contracture over the muscle?

Question

I will be having BA in a few months and my surgeon sais i could have implants under or over. I chose over and am worried now i am more at risk of cc?

Finny George, MD · Answer

Hi, thank you for sharing your question. Smooth implants placed above the muscle have the highest rate of capsular contracture. You can discuss subfascial placement with your surgeon to lower your risk, but below the muscle has the least risk for cc.

Gerald Minniti, MD, FACS · Answer

If your surgeon really said that without any information detailing the differences between over and under, then you should go to another surgeon. All smooth implants are more prone to cc over the muscle, but textured implants seem to resist it more. Textured implants have thicker more rupture prone shells however, and all implants over the muscle are more likely to be visible and palpable where you want it least, in the midline and upper breast areas. When proper implant selection and execution of the surgery is done well, smooth implants under the pec major do best over time.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to breast surgery and revision breast surgery.  From experience, I see significantly more problems with implants placed on top of the muscle versus below the muscle.  In fact, the rate of capsular contracture is double on top of the muscle and below the muscle. if you do not believe me, look at my gallery under revisions - "long-term changes of implants placed on top of the muscle".  Best wishes to you.

Ronald J. Edelson, MD · Answer

Most surgeons still feel that under the muscle is preferred. The incidence of capsule is probably lower but there have  even few reliable studies on whether that's true

Daniel Barrett, MD · Answer

Dear dianexxx,
capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

There is a lower risk of capsular contracture for implants placed below the muscle.  Another factor that can contribute are implants that are too large for the breast space.  There is no way to make the risk of occurrence zero, but these are factors to consider for your surgery.

Connie Hiers, MD, FACS · Answer

Yes, implants placed in front of the muscle have a higher chance of capsular contracture, but it still can be avoided in most cases.  Please discuss any concerns you have with your surgeon.

Douglas Taranow, DO, FACOS · Answer

While there is a higher rate of capsular contracture for smooth implants placed subgladular (above the muscle) vs sub muscular (below the muscle), the difference in rate is nominal.  I usually place my implants under the muscle unless the breasts are a bit droopy (protocol)
Dr. Taranow

Are Mentor smooth implants more prone to capsular contracture over the muscle?

Answers (8)

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