Move Breast Implants from Subglandular to Submuscular, 17 Yrs Later.

I have saline 210cc round over muscle implants placed 17yrs ago. Capsular contraction and rippling developed over the years and is painful. I am 5'7 125lbs. thin skin, very little natural breast tissue, with minor depressed sternum. Is it possible/recommended to swap them for silicone gel partial submuscular or could that create double bubble or windowshading? Is it ok to change from overs to unders after 17yrs? I would like to be similar size. Any particular projection recommended in this case?

Doctor Answers 11

Venue change for breast implants common in the treatment of capsular contracture.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Although there is no strong science behind it, I suggest to patients that have developed a contracture and want surgery to fix it that movement of the implant to a different site is a consideration.  The implant can be moved to subglandular or submuscular for the purpose of changing the biologic area in hopes of a better result.

Move Breast Implants from Subglandular to Submuscular, 17 Yrs Later.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I am sorry to hear about the complications you have experienced. Capsular contraction can be a very frustrating complication for both patients and surgeons. In my practice, I have found the most success treating these difficult problems utilizing techniques such as sub muscular pocket conversion (if relevant), capsulectomy, use of fresh implants (I am not convinced that there is a difference with smooth versus textured implants as long as the breast implants are in the sub muscular position), and the use of acellular dermal matrix. Acellular dermal matrix is a biologic implant that carries the ability to become integrated into native tissue. It is made by taking a full thickness section of skin from a donor source (his human, porcine, or bovine in origin). I hope this, and the attached link ( demonstrating a case utilizing acellular dermal matrix) helps.

Pocket Change subglandular to submuscular

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Change in pockets is what you need to make you look better.  You will still to remove the scar capsule from the original pocket  and your PS needs to take care not to connect the two pockets if possible.  Normally we release the muscle at the fold and the attachment to the breast tissue keeps it from going up like a window shade. In your case there is not attachment to the breast tissue as you previously had an implant above the muscle.  This operation is common but can be tricky.  In addition to this if you want to be the same size you are now you will need a bigger implant as they always looks smaller when under the muscle. 

Robert Kearney, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Implants location conversion

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Dear Baltimore resident,

   Being the thin person that you are, BMI of 19, you are the ideal candidate for the conversion from above the muscle to under the muscle. That will give you a thicker coverage of tissue over the implants since you do not have much breast tissue and your skin is quite thin. You will have to have "capsulectomy' in order to allow the pocket to expand and have a natural look. By geting the above plan, you pain and rippling will disappear. You can have either silicone or saline implants . Saline implants are significantly less expensive. In order to have the best result, be sure to consult with an experienced board certified plastic surgeon and check their before and after pictures.

                     Best of luck,

                                              Dr Widder

Pocket change from subglandular to submuscular

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is quite common to change the pocket from subglandular to submuscular.  Double bubble does not occur from the pocket change.  Some animation deformities may develop.

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

Move implants from subglandular to submuscular 17 years later?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is very common to change implant position from subglandular to submuscular (subpectoral), as this is recommended as a treatment for thin tissue with visible wrinkling and/or visible implant edges, and also a treatment for capsular contracture.  If the procedure is done properly, you should not get a double bubble deformity or windowshading.  A double bubble deformity can result from implants placed to high under the muscle without proper muscle release, or from a sagging breast that needs a breast lift and without the lift will hang off of the implant. Windowshading results from over-release of the pectoralis muscle off the sternum. If your procedure is performed by a plastic surgeon experienced in breast revision, these problems should not develop. As to your question regarding implant projections or profiles, we generally decide on which profile implant FOR A GIVEN SIZE matches in diameter best to your breast diameter and chest wall.

Moving to a Sub-pectoral pocket is possible

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi there-

While I would never be comfortable making size recommendations over the internet (this really does require an examination in order for the recommendations to be responsible), I can unequivocally tell you that placing your new implants under your muscle is possible and that a lovely result is possible.

The key will be to find an excellent surgeon.


New Submuscular Pocket is the Best Idea

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

With your history of capsular contracture and thin breast tissue, moving the new implants to the submuscular pocket is a good idea.  Silicone implants are also a good idea to get a more natural feel.  The main issue will be the laxity of the skin and location of the nipple; you may need a little bit of a lift.  The implant style can be chosen with your surgeon to get the best fit for your chest.  When you go under the muscle you will probably need a little bit larger implant to get the same feel.

Best Wishes

Dr. Peterson

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Subglandular to Submuscular Implants

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, from what you describe, you may be a good candidate to remove your saline sub glandular implants to the sub muscular position.  However, you would need to be seen in person for specific recommendations.  Switching to the sub muscular position would be very helpful in providing more tissue coverage to the implants and achieving a more natural appearance.


Good Luck.

Moving Implants Subglandular To Submuscular Should Improve Rippling

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There is no reason (with the information provided) that you cannot have your implants moved to a submuscular location.  I also agree with switching to gel implants.  This should greatly improve the rippling and also should lessen the chance of a recurrent capsular contracture.

John Whitt, MD (retired)
Louisville 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.