Would removing implants after a subfascial breast augmentation cause damage or other issues to the fascia?

Question

I have had implants placed sub glandular and ended up with capsular contracture. Many years later I had implants placed sub muscular and ended up with severe animation deformity (current situation). I am interested in subfascial placment as a possible way of helping to prevent these issues. "IF" subfascial implants ever had to be removed, would it destroy the fascia and cause other issues? Does fascia adhere to the implants making it very difficult to remove?

Derek Fletcher, MD · Answer

No, subfascial breast augmentation does not place you at risk of secondary soft tissue injury or significant muscle injury any more than the other methods of breast augmentation as long as your surgeon has the skill to perform the operation well. Removing subfascial implants is as easy as removing sub glandular implants.

Robert M. Wald, Jr., MD · Answer

Placing your implants in a sub glandular position will resolve your animation deformity. It's very common to place implants in a sub fascial plane. If you were to develop capsular contracture in the future, removing this tissue will have no consequences. An experienced surgeon does this procedure frequently and is not difficult to perform.

Ram Kalus, MD, FACS · Answer

Sorry to hear of your situation. In my own practice a subfascial pocket is my preferred first choice placement. In light of your previous sub glandular and current sub muscular placement, a fair amount of scarring can already be expected and it is difficult to predict exactly what outcome can be expected with either revision augmentation or subsequent permanent removal. As a rule, if you are in good health and your prior surgery was performed by experienced board certified plastic surgeons then the risk of significant post surgical scarring and deformity should be low. Unfortunately, the risk of capsular contracture is indeed higher in patients with your history of multiple prior surgeries, but that is a bell that cannot be unrung. If you are confident with your plastic surgeon, be sure he or she has experience with subfascial augmentation. Historically most plastic surgeons have performed subpectoral or dual plane with greatest frequency, and sub glandular, but subfascial is a relatively newer concept that not all plastic surgeons have embraced. Best of luck to you.

James Knoetgen, III, MD · Answer

Removing breast implants after a subfascial breast augmentation may have some implications for the fascia, but the extent of these implications can vary based on individual factors and the specifics of the surgery. Here's some information to consider:

1.) Fascial Disruption: Subfascial breast augmentation involves placing the breast implants beneath the fascia, a layer of connective tissue that covers the muscles. When implants are removed, there is a possibility of disrupting the fascial tissue. The extent of disruption can depend on factors such as the surgical technique used for implant placement and the condition of the fascia at the time of implant removal.

2.) Tissue Healing: The body has a remarkable ability to heal itself. After implant removal, the fascia will naturally undergo a healing process. However, the healing may result in some changes to the fascial structure, which could potentially lead to differences in breast appearance, texture, or sensation.

3.) Consultation with a Surgeon: If you are considering removing breast implants after a subfascial breast augmentation, it's crucial to consult with a qualified and experienced plastic surgeon. They can assess your individual case, evaluate the condition of the fascia, and provide guidance on the potential impact of implant removal on the fascial tissue.

4.) Possible Complications: While most individuals do not experience significant issues with fascial damage or disruption during implant removal, there is always some level of risk associated with any surgical procedure. Your surgeon will discuss potential complications and outcomes based on your specific situation.

5.) Recovery and Healing: After implant removal, the body will need time to heal. This may involve some discomfort, swelling, and changes in breast appearance. Following your surgeon's post-operative instructions and attending follow-up appointments are important for monitoring your recovery.

It's important to have a thorough discussion with your surgeon about your concerns and expectations. They can provide you with personalized information based on your unique situation, helping you make an informed decision about breast implant removal and potential impacts on the fascia.

We would be happy to discuss this with you in more detail. Please visit us online to request a consultation or chat with our friendly appointment coordinators via live chat.

Connie Hiers, MD, FACS · Answer

If you choose smooth implants, no tissue adheres to the implants and removal is not disruptive to tissue. If a capsule needs to be removed, some tissue is removed, but it is mainly scar tissue.

Would removing implants after a subfascial breast augmentation cause damage or other issues to the fascia?

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