4th revision - can one implant be placed in front of the muscle and leave the other behind?

Question

I had a rupture of the right implant that I only noticed due to waking up to swelling up to my collar bone. I’ve had 3 revisions trying to fix it thru the same doctor but the implant keeps falling. She has used mesh twice and sutured to chest wall. It all has failed. Now she wants to put that one implant in front of muscle and leave the other behind. Is all this normal? Is it normal and is it going to look ok to have them in different spots?

Wayne I. Yamahata, MD · Answer

Implants may look equally good when placed either above or below the muscle, but typically they do look different. If you will be putting one implant above the muscle, you will likely have better symmetry by putting the other above as well.

Emmanuel De La Cruz, MD · Answer

While it is technically possible to place breast implants in different positions (one in front of the muscle and the other behind), it is not a common or recommended practice. Breast augmentation is typically performed with both implants placed in a consistent position to achieve symmetry, balance, and optimal aesthetic results.

Placing implants in different positions can lead to noticeable asymmetry in the appearance, feel, and movement of the breasts. It may also increase the risk of complications, including an uneven implant pocket, differences in how the implants settle over time, and potential distortion of breast shape.

In most breast augmentation surgeries, the choice of implant placement—either submuscular (behind the chest muscle) or subglandular (in front of the chest muscle)—is made based on various factors, including the patient's anatomy, breast tissue characteristics, and the surgeon's preferences.

If you have concerns about breast asymmetry or are considering breast augmentation, it's crucial to discuss your goals and expectations with a board-certified plastic surgeon. They will assess your unique anatomy, discuss the most appropriate implant placement for your situation, and provide recommendations to achieve the desired outcome. Consistent implant placement is a key element in achieving natural-looking and symmetrical results in breast augmentation

John L. Burns Jr., MD · Answer

In my opinion, it is always best to have both implants in the same position.  Placing an implant in a sub glandular pocket won't prevent it from dropping.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to breast revision surgery.  Without seeing your picture, it is very difficult to understand what is going on.  In over 28 years in practice, I have never had to relocate an implant on top of the muscle wall leaving the other one under the muscle.  There are very few breasts that I have not been able to fix.  Best wishes to you.

Gary M. Horndeski, MD · Answer

Placing one implant in front of the muscle and keeping the opposite behind the muscle will most likely result in an asymmetrical appearance.  You are better off having both implants behind the muscle.

Best Wishes,

Gary Horndeski, M.D.

4th revision - can one implant be placed in front of the muscle and leave the other behind?

Answers (8)

Answer: Breast revision

Answer: Breast revision

Answer: Asymmetrical appearance

Answer: Asymmetrical appearance

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Everything you need to know about Breast Implant Revision

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4th revision - can one implant be placed in front of the muscle and leave the other behind?

Answers (8)

Answer: Breast revision

Answer: Breast revision

Answer: Asymmetrical appearance

Answer: Asymmetrical appearance

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.