Revision BA: 275 Subglandular Saline to 250 Submuscular Silicone? (photo)

Hi all, I am 34 year old 5'4, 120 lbs. had a BA in 2006 with Mentor round moderate saline implants. After having a child and breasfeeding in 2009 and spoke to a plastic surgeon and he mentioned capsular contracture and/or rupture. Would a capsulectomy or capsulotomy do? Would I achieve similar results with 225cc silicone? Also- is there any possibility I may be able to get them in the submuscular position (not recommended the first time)

Doctor Answers 4

Deflated Saline Implant

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Looking at your photos, it appears to me that your right implant leaked. There is also some ptosis. If you are not too concerend about the sagging, replacement with much larger silicone implants, preferably in the same subglandular location, should fill the breast skin better.  If you want to stay with the samesize,consider a lift and if you don't mind the scars that will result from a lift, a sbumuscular location of the implants is fine.

Allentown Plastic Surgeon

Breast implants - capsule or deflation?

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Thank you for your question about your saline breast implants.
• Is one side becoming smaller? If so, it suggests a slow leak from your saline implant - this happens often.
• If you are happy with your implants, removing and replacing a deflating one is easy. I often do these in the office with local anesthesia.
• If it is a capsule, you and your plastic surgeon need to discuss options in detail - above the muscle or below? Saline implant or gel? Breast lift or not?
Hope this helps. Best wishes!

Revision BA: 275 Subglandular Saline to 250 Submuscular Silicone? (photo)

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If you have a capsule, it should probably be removed. I would suggest going slightly larger with a silicone implant in a submusclar position. This should minimize your chances of future getting a capsular contracture.

J. Timothy Katzen, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 254 reviews

Revision BA: 275 Subglandular Saline to 250 Submuscular Silicone?

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Thanks for you question and posted photos. It would be helpful to know what it is that you would like to see and feel about the breasts that would reach your goals. 

It is usually quite easy to diagnose a leak in a saline implant. Usually the deflate almost completely within 24 hours. After four years you can exclude that possibility. 

I can see what I believe is the outline of the implant the left (? assuming this is a mirror photo) which would be suggestive of capsular contracture. Typically, that implant would feel abnormally firm, and that finding is not noted in your question. 

Chances are I would recommend repositioning the implants behind the muscle, and switching to silicone. As to size, that would depend upon your goal. 

If your current size is satisfactory, I would use the same or slightly (25cc) larger implants. If your preference were to be larger or smaller, the implant chosen would reflect that wish. 

I would think twice about a surgeon who thought you had a leak. When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, 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.