Revision surgery - going from under muscle to over muscle. Any suggestions?

In Feb., 2015 I had a breast lift with 375 cc smooth round high profile implants placed under the muscle. In Aug. 2015 I had a revision surgery on the left breast (the implant was clearly visible, but PS said it was CC). Now I am facing another revision with a new doctor who I trust and who is recommending removing the implants from below the muscle and placing new textured implants over the muscle. Why is it so difficult to find info on this type of surgery?

Doctor Answers 3

Revision breast implants

Without seeing you in person it's hard to make a recommendation. If recurrent capsular contracture is the issue, then in my opinion, it would be better to either make a new sub muscular pocket between the old capsule and the muscle or take the bottom of the capsule out and replace it with a piece of Strattice. By visibility, I'm assuming either seeing the edge of the implant, or seeing wrinkling both of which would be better masked when implanted under the muscle. Good luck with your upcoming surgery.

Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Going from under muscle to over muscle.

Generally the approach to capsular contracture is a new pocket and implant placed under the muscle for the lowest recurrence rate. Many will also recommend an allograft material such as Strattice to help interrupt a new contracture. A high profile implant over the muscle even with texturing has a lower sucess rate and might show through or appear round.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Finding information

On the balance, it is more common to replace implants into a new pocket under the muscle rather than over the muscle.  That may have something to do with why you are finding it difficult to locate information about this surgery.  My guess is that your new surgeon is concerned about contracture so the recommendation is for textured implants in a new position. That is a reasonable suggestion if I am guessing correctly.  Good luck!

Nathan W. Patterson, MD, FACS
Pensacola Plastic Surgeon
5.0 out of 5 stars 20 reviews

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