Is full muscle coverage placement of a breast implant stronger and will it hold implant in place more than the capsulorrhaphy?

I got breast implants about 7 years ago and I've had 2 kids since. My breast implants definitely dropped and go to the side when I lay down. I went to a BA consultation and he's recommending anchor lift with full muscle coverage placement of implant and will only go up to a max of 450cc's. 2nd consultation I went to recommended I get a capsulorraphy to prevent implants from going to the side and also a lift with 600cc's which I want. But first dr. is saying i do not need a capsulorraphy?

Doctor Answers 7

Full muscle coverage fro implants -no!

I have a number of revision patients I have fixed who have had this "full muscle coverage" surgery to control implant position. The surgeon lifts up both the pectoral and serratus muscle to make a complete internal pocket. The problem is that the patients I revised were in very serious pain and had serratus muscle weakness (look up "winged scapula"). In addition the pocket didn't "hold" the implant and do the job it was intended to do. Personally, I recommend either the capsullorrhaphy or placement of acellular dermal matrix (ADM). In my opinion if you are going up to 600cc, then use the ADM, or else the capsulorrhaphy won't be strong enough to hold that big implant in the right location. After all, the capsule failed you in the first place, why would it work now?


Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Full Muscle Coverage is Impossible

Hello,I believe you've already posted, but aside from the fact that you would need to be examined for any of us to give cogent recommendations, this concept of 'full muscle coverage' in really does not exist. The other muscles of the chest wall, which include the pectoralis minor, the serratus anterior, and the rectus abdominus, are all thin, flimsy muscles that are densely adherent to the rib cage.  They frequently do not form a confluent layer that would even entirely cover an implant. Elevation from the rib cage causes unavoidable injury to many blood vessels and pain fibers surrounding the ribs, which leads to significant pain, edema, and possible bruising. Go visit a few ABPS certified/ASAPS member surgeons that specialize in revision breast surgery.Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Implant revision

Without seeing you in person it is very difficult to suggest what might be right for you.  Surgeons are all different and opinions may be different in how to give you the best result based upon experience. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Is full muscle coverage placement of a breast implant stronger and will it hold implant in place more than the capsulorrhaphy?

Thank you for the question. This has many components that will be hard to accurately answer because I do not know much about your soft tissue envelope. Is it thin or not, do you have good breast tissue covering the implant. So it is hard to say. I will speak generally and I have no idea if your implants are above or below the muscle. When you say he recommends full muscle coverage you are indicating to me they are above he muscle. This forum would not be the right place to get into which is better. So in general under the muscle is great for women who have thin skin and tissue. It offers better coverage than above the muscle. Being that said if a patient like you has implants above the muscle I would only change to below the muscle if it is needed for more coverage and I can only know that by exam. If the implants are off to the side it is either because the skin is very lose and the lift will take care of that or the implant has stretched the capsule over time and that will require a capsulorraghy. To best recommend I need more information, but it sounds like you need a lift for sure, and whether you need to have a pocket position change to below the muscle is unclear to me. Sincerely, 
DrRickAZ

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 45 reviews

Repair

Thank you for the question and if you have concerns about the opinions you have been given go on more complimentary consultations with experts in your area and be examined
Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 59 reviews

Is full muscle coverage placement of a breast implant stronger and will it hold implant in place more than the capsulorrhaphy?

Thank you for the question. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.  

Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon carefully. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. ***If I were you, I would ask to see as many examples as possible of similar patients who your plastic surgeons have helped.

I am not sure what you mean by "full muscle coverage";  generally, the pectorals major muscle sits high on the chest wall and full coverage  of breast implants is not technically possible.  Therefore, most sub muscular breast augmentation procedures actually involve a "dual plane" (partially sub muscular, partially sub glandular) positioning  of the implants.   Keep in mind, that  animation/flexion deformity is a potential problem with breast implants that do not have sufficient sub glandular component coverage to them.

 Again, ultimately you will need to be very careful in selecting your plastic surgeon carefully. Then, communicate your concerns/goals carefully as well. Working together you will come up with a good plan to achieve an outcome you will be happier with.

Best wishes.

Revision breast surgery comes in many forms

Capsulorraphy is the repair of implant pocket.  The idea is to prevent displacement and poor breast contour after surgery.  Breast lift, meanwhile, aims to address soft tissue laxity, leading to a perkier, more youthful appearance.

Take note that each doctor has his own customized approach, which of course must be based on the patient's underlying anatomies and cosmetic problems, and her personal preference and aesthetic goals as well.  For this reason you must scrutinize the surgeons' before-and-after photos because they can reveal a lot about their level of artistic and technical skills.

Also, using implants that are smaller or conservative in size--or at least something that reflects your underlying anatomies, particularly your soft tissue coverage, body frame, and chest/breast dimension--is another crucial step to avoid implant displacement from recurring. 

I hope that helps and good luck.

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.