I'm looking to do implant exchange from over to under the muscle. Suggestions?

I am 5'2", weigh 120lbs & my chest width is 11.7 inches. I currently have 350ml saline implants over the muscle for 12 years. Lots of sagging. I am a 32 DD & would like to stay that size. Definitely NOT bigger. Am considering high profile silicone under the muscle exchange with a lift at a later date as suggested by Dr. What would be an appropriate implant to keep me around the same size now? Would 350ml be ok or should I go with higher volume?

Doctor Answers 5

When changing pockets

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from above the muscle to below, you have to be ready to accept the movement of your breasts that you've not had to deal with since your first procedure.  If you have contractures you are dealing with, going under the muscle can help but you can also stay above the muscle with shaped, textured implants but this requires a lot of work to create the perfect pocket needed for textured implants.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Drooping of breast with over the muscle implant

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I would highly recommend that you consider having only a single surgery to address your concern; this will require replacing the implant in a submuscular pocket as well as a lift at the same time; if you are going to fix your concerns just get it done in one session. Just changing implant style is not going to correct your concern. Please see examples below.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 106 reviews

I'm looking to do implant exchange from over to under the muscle.

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Changing from saline subglandular to silicone subpectoral implants is often a very good idea to improve the naturalness and feel of your breasts.  I prefer to choose the final implant size from a variety of implants using "sizers" placed into the new pocket at the time of the procedure when actual results can be seen.  My preference is toward mid or mid+profile implants and not hp implants but some will disagree.  You will need to have a larger volume in the subpectoral position to maintain a similar apparent size to your current saline subglandular implants.  Best wishes,

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

Implant Exchange Saline to Silicone

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In general to keep the same look that a patient had with saline implants, it is necessary to go slight bigger with silicone implants to keep the same look.

When a patient desires to stay the same size as their previous implants, I generally assess the dimensions of the saline implant and then choose a silicone implant that has the same or similar dimensions.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews


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Thank you for the question and sounds like you are on the right track.  So follow your surgeons advice or see other experts in the area and get opinions after an examination

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

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.