This is a great question. I see many patients in my practice interested in placing implants under the muscle after having been placed over the muscle. This type of surgery can be performed in one stage. I do advise seeking an experienced plastic surgeon. The difficulty in this surgery is preserving the outside border of the breast pocket while under the muscle as well as preventing the muscle from retracting upward. With careful dissection and an experienced surgeon, this should not be a problem. The edge of the muscle can be stitched to the breast tissue in an appropriate position. Then the original pocket can be addressed in a way that the 2 surfaces stick to each other and adhere back down to the muscle.
Thank you for the question. 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. 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 examples of revisionary breast surgery cases, helps. Best wishes.
In my experience this can usually be done in one procedure with a closing off of the subglandular space with multiple sutures to the underlying muscle. Then, especially if larger implants are desired, in order to prevent the now released muscle from rotating upward a fairly large piece of Strattice has been helpful in completing this procedure in one stage. Find a board certified plastic surgeon in your region with demonstrated experience in complicated breast revision surgery. Best of luck.
Smooth implants under the muscle is a much better choice. You need to find a surgeon that is experienced in this matter.