In my right breast I can feel the implant poking out. They are over the muscle and 13 years old. Can I get them under muscle?

I have had my implants for 13 years done.over the muscle at 450 cc saline, and a year ago the right one started protruding out. I can feel it through a bra. I want to get them re done under the muscle, but I have had a consultation and the doctor said he doesn't do cases like mine. Obviously, I need to find someone who does. How risky is it, and how soon should I get it fixed?

Doctor Answers 8

A revision can certainly be done

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
and improve your current situation.  Depending on what your anatomy is like, the technique will vary.  If your implant is poking out with a palpable tip, you really need to get this done asap.  Most experienced surgeons should be able to accommodate your needs and produce a satisfactory outcome.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

A breast augmentation revision is recommended

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It appears that the tissues overlying the implant have thinned. This is often a progressive problem that can ultimately lead to implant exposure and potential loss of the implant. The recommended treatment is to increase the tissue coverage and one way to achieve this is to move the implants under the muscle. This is generally the recommended approach as there of often other benefits to moving the implants under the muscle as well.
I hope this is helpful and you are able to have this corrected in a timely fashion. 

Wayne I. Yamahata, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 50 reviews

In my right breast I can feel the implant poking out. They are over the muscle and 13 years old. Place them under the muscle?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
If the tissue coverage over the implants has become thin and/or you have developed a crease or kink in the implant which you can feel, you may be a good candidate for a breast augmentation revision.  One option wound be to place new implants under the muscle.  Another option may be to use a graft (acellular dermal matrix) which can be used to help support and cover an implant.  Seek out a board certified plastic surgeon in your area.  They should be able to help you choose the best option in your case.  Best wishes, Dr. Lepore.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

In my right breast I can feel the implant poking out. They are over the muscle and 13 years old. Can I get them under muscle?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. This is a very common problem and revision surgery to replace the implant into a new pocket under the muscle is a very good approach that can offer excellent results. I am guessing that your surgeon said that because he has little experience with this type of surgery. I would suggest that you make sure you are being seen by a board certified (ABPS) plastic surgeon for your consultation. They can properly advise you on what needs to be done to achieve your goals.

Best of luck and be safe!

Switching from over to under muscle implants is commonly done

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Switching from over to under with implant exchange from saline to silicone is a commonly done operation. The high fill ratio implants such as Allergan's Inspira and Sientra's 106/206 series have less rippling than earlier types of silicone implants, and silicone implants in general ripple less than saline. Keep in mind that the muscle does not cover the entire implant, so you may still feel the implants on the outside and bottom of the breasts. Saline implants especially when over the muscle tend to cause more sagging over time, so a lift may be needed.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

In my right breast I can feel the implant poking out. They are over the muscle and 13 years old. Can I get them under muscle?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Exchanging to a cohesive smooth silicone gel implant beneath the pectoral muscle will offer several advantages to you.  Try to resist the temptation of going larger to reduce the rippling or folds in your implant.  Placing the implant partially subpectoral will provide extra coverage over the implant in the upper half of your breast but not change the lower half or outer portion.  The major improvement in those areas will be from the change from saline to cohesive gel.
Meet with a couple of ABPS Bd Certified experts in your area to discuss your options.  
Your story represents a good example of the shortcomings of subglandular (especially saline) implant placement over the course of time.  Good luck and best wishes.

Jon A Perlman MD FACS
Certified, American Board of Plastic Surgery
Extreme Makeover Surgeon ABC TV
Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Changing implants from over to under the muscle

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Yes, your situation is fairly common and the procedure you want is done frequently by many of us. Most of the patients change to the silicone implant and their postoperative comment is almost always the same...."I can't believe I didn't do this sooner". It's a significant and very pleasing change. Just make sure you use a surgeon experienced and successful in this operation. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Conversion to sub muscular augmentation possible?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
 I am sorry to hear about the problem you are experiencing. Often, it is possible to perform the operation you are considering in a single stage (possible to convert sub glandular breast implants in to the sub muscular (dual plane) position). Successful results do depend, to some degree, on the surgeon's experience. Therefore, best to make sure that your plastic surgeon can demonstrate significant experience helping patients with this type of revisionary breast surgery.

Sometimes, patients undergoing conversion of breast implant positioning from the sub glandular to the sub muscular space benefit from additional maneuvers such as breast lifting (depending on the position of the breast skin envelope in relation to the position of the sub muscular breast implants) and/or the use of acellular dermal matrix for lower pole support and/or additional coverage of breast implants. Closing off the existing breast implant pocket is a technique utilized to help prevent the breast implant from moving back into its previous space.
I hope this, and the attached link demonstrating many relevant  cases, helps. Best wishes.

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.