Should I replace sub pectoral high profile saline implants with anatomically correct silicone implants over the muscle? (Photo)

I am ready to undergo my third breast surgery. 1st and 2nd surgeries were saline implants placed under the muscle. I am 32, 5'1" and around 100 ibs. The surgeon I am considering has proposed anatomically correct silicone implants, placed over the muscle and estimated time of my surgery is five hours. I am freaking out. Cost will be 25 k. Is this really the best option? Is there a less extreme, but equally effective way to go, given all of this?

Doctor Answers 7

When to consider shaped implants

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First, the term "anatomically correct" is often a misnomer, as for most patients round implants are anatomically correct; form-stable shaped implants are used for certain situations. These include breast reconstruction, and certain breast shapes. Under muscle is usually best. The picture appears to show some asymmetry of nipple position, which would not be corrected by changing to shaped implants. It is usually best to get a second opinion especially when the cost is high and it is the third operation.

There should be a good reason before revisional surgery was undertaken after breast augmentation.

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I'm not exactly sure the reason you're having the implants replaced. Why a revisional procedure would take five hours I really have no idea. Perhaps you should get a second opinion.

Why are you wanting another procedure?

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What are you trying to correct and make better?  Without knowing this, I wouldn't suggest any surgery at all.  And as for fees, you could probably shop around and find a better fee for the same service (shaped implants over the muscle) or you can ask your surgeon why this is taking 5 hours as most average surgeons can get it done in 3 hours or less.  Without knowing your goals, unable to provide you a 'best option'.

Anatomic vs round implants

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What is your reason for changing implants?Rippling of the saline implants would be one reason to change to a silicone implant. Another reason would be capsular contracture(hardening). Normally the thinner you are the less coverage you will have over the implant if it is placed above the muscle.  Five hours to change out implants seems very excessive. I think a round gel implant  would give you a nice result. I agree the shaped implants are great for certain situations.

Jon Rast, M.D.

Jon E. Rast, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 35 reviews

Third breast surgery

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Thank you for your pictures. You should send better pictures with multiple views. I think there are other options than changing sites and going to anatomic implant. The additional pictures will help determine your other options.

What are the reasons you need a third procedure

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Thanks for your question and photograph post. From you photo I do not immediately see the problem you are trying to correct.  If it is just to switch to gel implants you would do better with a round gel than an anatomic implant.  What are the reasons you need a third procedure?

Implant replacement

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Thank you for your question. I have several concerns after reading your post- What are the reasons you are exchanging your implants for the 3rd time? Do you currently have problems with capsular contracture? Is your surgeon planning to use ADM or some type of capsular repair?    The cost and duration of your proposed surgery do seem high. Anatomic implants are nice in the right patient but you are going from a submuscular saline implant to a subglandular anatomic implant. Perhaps there are some other factors about your history or exam that you did not include in your post.

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