Can I go from subfascial to submuscular (been told I've large pockets)? (Photos)

Question

I had subfascial implants 10 plus years ago and am done with having children they sagged quite quick after having them done and after seeing the surgeon was offered a lift I was hesitant as I was under 20 and wanted to wait till I had a family. I have thin breast skin and can feel the implants and ripple I’d like a lift and slightly larger implants and to go under .. can I go from over to unders after being told I have large pockets .. I have no capsular contracture .

Gary M. Horndeski, MD · Answer

The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Donald R. Revis Jr, MD · Answer

Good morning,
Absolutely- I did that for a patient on Monday and will be doing that for another patient today. Switch to unders, use the Original Internal Bra to close the old pockets, place a drain for five days, and do a donut mastopexy! They will look so much better!

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to revisionary breast surgery.  Performing a site change or pocket reposition is a very common procedure in my practice.  In fact, I wrote a paper on this very topic which can be viewed under my bio in publications.  You are an excellent candidate for this surgery.  Best wishes to you.

Daniel Barrett, MD · Answer

Dear Millie54321,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Richard Baxter, MD · Answer

It is probably a good idea to go under muscle with your new implants and lift, because your tissues are so thin. My preference is split muscle rather than dual plane in order to minimize the risk of animation deformities. Other options for coverage are internal bra materials such as Galaflex and Strattice ADM.

Connie Hiers, MD, FACS · Answer

Just based on your photos, you would do well placing the implants behind the muscle for better coverage and support and a lift, but I would suggest not going larger than what is best for your frame and tissue.

Can I go from subfascial to submuscular (been told I've large pockets)? (Photos)

Answers (6)

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