Replacing 17 year old implants. Opinion on switching old breast implant placement to dual plane - is it possible?

Question

Hello, I have old breast implants that I am ready to replace since having 6 children and breastfeeding them all! This initial breast augmentation was done 17 years ago, with an over the muscle placement. I am 5'1" 113lbs and workout with weights, kickboxing, plyo etc. I have capsular contracture that set in around 2019. I had a consultation but was told that the Dr would not be able to switch the placement to dual-plane (his preferred placement) due to my having little breast tissue now, and that my current implants have been over the muscle this long. Should I get a second opinion? Is this possible at this point to change the placement? Regardless, it is time to switch these out. I am staying around the same size which is 280CC silicone.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice over 30 years and revision breast surgery is a large portion of my practice.  I do see a lot of women who have implants on top of the muscle.  The likelihood of capsular contracture is twice as common as under the muscle.  Additionally, many people who have implants on top of the muscle have "slide down" in which the breast travels down there chest to a low position.  I have written the only technical paper on replacing implants from on top to below the muscle.  Oftentimes, you will also need a lift.  Even though you do not have much breast tissue, you should be able to have an excellent result.  Best wishes to you.

Mats Hagstrom, MD (license on probation) · Answer

There’s no right or wrong way to approach this.
Converting to a sub muscular position has certain advantages and disadvantages.
It would potentially lower the chance of rede developing a capsule contraction.
Having context to when and why the capsule contraction formed could be important information.
 The definition of dual plan is somewhat subjective and arbitrary.
All sub muscular augmentations are in fact, dual plane since the muscle can never cover the lower part of the implant.
It’s simply a matter at what level the pectoralis muscle is transected or taken off the rib cage.
Personally, I like to leave as much muscle covering the implant as possible, and only release enough muscle for the implant to sit in the correct position.
Working with smaller implants is usually safer and easier.
If you convert to a sub muscular augmentation, then you may need several months for the tissues to readjust.
Some surgeons may have a little experience with converting from sub glandular to sub muscular.
If this is important to you then Find a plastic surgeon who has a lot of experience doing the procedure.
Depending on what the ideology is for the capsular contraction. You are at risk for this happening again, especially if you use the same anatomic position above the muscle.
Provider selection is usually the most important variable.
Finding the right plastic surgeon is not easy or straightforward.
It does usually involve having multiple in person consultations and the ability to vet plastic surgeons.
 Good luck,
Mats Hagstrom MD

Replacing 17 year old implants. Opinion on switching old breast implant placement to dual plane - is it possible?

Answers (2)

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.

Replacing 17 year old implants. Opinion on switching old breast implant placement to dual plane - is it possible?

Answers (2)

Browse related questions

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.