Hi! I am 31 5' 113 no kids. I had a saline boob job under the muscle in 98. I feel like they are moving apart from one another? They say you should change after ten years due to new technology, product is better. Is it normal for them to move closer to my arm pitts? Still want a family is the new silicone ok for under muscle and breast feeding in the future?
Doctor Answers 9
The breast implants are medical devices that can change in shape or placement over years. This does not mean there is any treat to your health keep in mind. A capsular contracture can be a very strong force and move an implant in any direction, over time. The removal/replacement is not a 10 year mandate. However, if there is an aesthetic change and surgery is indicated replacement should be considered.
Migrating Breast Implants
Implants moving as you describe is usually caused by them being under the muscle and the muscle having inferior attachment to the chest wall. This could be because they were left that way at the original surgery or they reattached. The implants are not the problem and there is no reason to change them, just because they are old, unless the displacement bothers you.
Implants can move apart from each other
Your implants appear to be moving out to the armpits after twelve years? This is likely due to their placement under the muscle and this can be corrected by several techniques (sutures, capsulorrhaphy, acellular matrix, etc.) for closing the lateral pocket and releasing the lower muscle attachments. The average need for implant replacement is 10 to 15 years, but I have seen patients as long as 25 years with their original implants doing well. Breast feeding is still possible with silicone implants behind the muscle. Have a discussion with your surgeon on the pros and cons of silicone gel vs. cohesive gel vs. saline vs. fat transfer for what best fits your situation.
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There is NO rule that implants are exchanged every ten years!. You are not having an implant issue. You are having a pocket issue. Yes the silicones are safe. Seek in person evaluations to become more informed about your options.
If your implants are shifting into yoru armpit, then the pocket is to big and usually needs to be closed down a bit. Silicone are safe implants.
Subpectoral Implants driven out by pectoral muscle
Silicone Breast implants are not the issue. You didn't mention the approach that was taken - inframammary, transaxillary or periareolar. Contraction of the pectoral muscle will drive any implant "down and out". I tell my patients not to do chest exercises when their implant are under the muscle. Strengthening of the muscle will accentuate the breast implant separation. Capsular Contracture wil also shift the implant up and in the case of transxillary approach implant will displace the implant toward the arm pit area.
I use silicone implants subpectorally usually through a inframammary or breast crease approach. No problems with breast feeding. I also release the pectoral muscle to weaken the ability of the muscle to drive the implants apart.
You need a thorough examination to determine what's going on and recommendations will follow based on the findings. Hope this information helps you!
Dr. James Matas
There is no reason to exchange your implants simply because of new technology. If your implants have migrated laterally to a significant degree, then I agree that a capsulorrhaphy would be appropriate. If you have this done, you could exchange your saline implants for silicone which should have no ill effects on later breast feeding.
Implants moving toward the armpits
Saline implants, especially in thin patients whose chest walls angle outward naturally, have a tendancy to migrate with gravity over time toward the armpits. This can be corrected by placing stitches in the gutter and pushing the implants back up and in. It can recur so follow the instructions of an experienced plastic surgeon carefully during the healing phase which lasts about 3 months.
Exchanging Breast Implants
I have seen this issue (implants moving into the armpit) with many patients and usually the way to correct this is with capsulorrhaphy (internal sutures). The internal sutures are placed to improve the implant position on your chest. I do this procedure weekly and the patients are very happy with their results. This surgery requires significant recovery time (no heavy lifting) so that everything heals appropriately. Make sure your surgeon has done this procedure successfully (ask to see photos or speak with other patients).
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