Over Muscle Implants Ruptured; Can I Get Smaller and Under Muscle As Replacement?

Had skin nipple sparing dbl proph mast in 07. Saline wrinkled. 4 mos later silicone implants on top of muscle. Developed capsular contraction on one side and raised scars under both breasts. Another operation to correct. Current problems: once again developed cc on and just found both implants are ruptured! Current silicone implants are high profile and too big for my frame (700ccs)! If I am going replace the implants, I would ideally like smaller and under muscle is this possible? HELP!

Doctor Answers 4

Breast Revision with Smaller Implants

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Yes, it is possible to #increase your implant size with a #revision. However, the #pocket will need adjustment and a lift may be necessary; to better #support the new implant. Additionally, a mesh for further support may be helpful depending on the #implant size and skin #elasticity.


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Getting smaller implants under the muscle and going with saline would sound to be the correct choice. Without and exam it’s hard to be exact. You should see a certified plastic surgeon to go over your options.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

Over Muscle Implants Ruptured; Can I Get Smaller and Under Muscle As Replacement?

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Dear Gerri2360,

On the surface, there does not seem to be any clear reason that you cannot choose to have your current implants removed and replaced with smaller implants placed under the muscle. Use of acellular dermal matrix may also be advisable.

Please see an experienced, Board Certified Plastic Surgeon for an evaluation and discussion of your options. It would be in your best interests to have copies of your medical records sent to your surgeon before you visit.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon

Can I Get Smaller and Under Muscle As Replacement?

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I can think of no reason why you couldn't get smaller implants and have them placed under the muscle. With a history of two capsular contractures, most surgeons would prefer placing them under the muscle anyway.

Your srugeon may also recommend the use of an acellular dermis as part of the procedure to give the implant additional support, and to reduce the chances of a recurrence of capsular contracture.

Good luck and best wishes.

Jourdan Gottlieb, MD
Seattle 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.