Redo Breast Augmentation?

I had my subglandular augmentation done about 9 or 10 years ago. I was mostly happy with the surgeon had very little pain, no noticeable scarring. However , he overfilled and removed some of the saline after an overfill and subsequently I had rippling (I feel more quickly than I should have) I am not a large woman 5'7 130 #. Can I have the implants redone submuscular or would that make my breast look deformed or should I stick with subglandular and have them replaced ?

Doctor Answers 5

Redo breast augmentation

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The situation you describe is fairly typical with  Subglandular saline implants in wrinkling. While it is certainly possible to switch to silicone implants under the muscle ( the best way to avoid wrinkling), this is often  easier said than done. For one thing, the underlying pectoralis muscle has probably been stand out from the pressure of the overlying implant. Because there is now a sub glandular and sub muscular pocket, the implant may want to slip out from the sub muscular pocket back into the sub glandular pocket unless special measures are taken. You also must be prepared to have loose skin over the implant until it has had time to re-mold to the new implant. An easier solution might be to simply put a silicone implant into the existing pocket

Denver Plastic Surgeon

Redo breast augmentation

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You describe well the limitations of saline implants, especially in the subglandular plane.  Either the surgeon overfills them, which may result in an overly firm breast with a harsh upper pole transition, or the surgeon underfills them with the result of rippling.  In general silicone gel implants have much better behavior, especially in the plane under the pectoral muscles.  Please see a surgeon certified by the American Board of Plastic Surgery who has significant experience with revisional breast surgery.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Redo breast augmentation?

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Thank you for your question. In order to give a really meaningful answer you need to be examined by a board certified plastic surgeon. However, given your history it would appear that you would benefit from having your saline implants replaced with silicone and having them placed in the sub muscular plane.  This should not cause your breasts to become deformed.  However, this can only be determined by having a board certified plastic surgeon examine you.  Be sure to express your concerns to him/her.  Best of luck.

Dr. Donald Brown. 

Donald M. Brown, MD (retired)
San Francisco Plastic Surgeon

Repositioning implants is reasonable

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It sounds like you have had a fairly typical experience with subglandular implants.  After so many years it is not uncommon to see thinning of the tissues and implant ripples.  Most of the time the right answer is to change the pocket to a submuscular pocket and use silicone implants.  The issue I can not answer for you is the results of the breast skin and how much drooping you may have.  If you go up on the implant size a little bit you should maintain the current appearance of the breast.

Discuss your goals clearly with your plastic surgeon.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Repositioning of Breast Implants from Sub glandular to Sub muscular Position?

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As you can imagine, it is not possible to provide you with precise advice without direct examination and a full communication of your goals. However, generally speaking, if at all possible, (given your concerns about rippling…),  it will be in your best interests to have the breast implants replaced in the sub muscular (dual plane) position. Whether or not you will do well with this type of breast implant repositioning will depend on your physical examination and the nature of the overlying breast skin envelope. Some patients' breast tissues will re-drape nicely over the repositioned breast implants;  some patients may benefit from breast lifting as well.  The use of acellular dermal matrix may also be helpful for patients with significant rippling.

 I would suggest that you meet with board-certified plastic surgeons who can demonstrate significant experience helping patients with your concerns.

Best wishes.

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.