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To reimplant or not to reimplant- what are your thoughts?

Q:

I had subglandular saline implant surgery in 2001.  One implant ruptured 3 months ago.  I need to remove the old implants completely but I'm not sure about reimplanting.  My surgeon said just a breast lift only for my limited breast tissue is NOT an option.  She'd place the new implants under the muscle.  The reasons I'm not sure about replacing them now: Implant deflation again with submuscular surgery next time. I'm a runner and I do strength training exercises.  I'm concerned about lengthy recovery time.  Any advice please?

A:

Without more information, such as how much native breast tissue you have and how larger the previous breast implants were, it is impossible to advise you precisely. That being said, it is very common for breast tissue to atrophy after implant insertion. That may make it harder to do a lift without an implant and get a reasonable size. However, you are the only person who can make the decision about not putting another implant back. If the breast with the deflated implant is slightly larger than you would like your breasts to be, then you could opt for just removing the implants and doing a lift. If you would like to be that size or larger, you need to have the implants replaced. This time I would suggest using silicone implants. With the new cohesive gel implants, you really should not have to worry about rupture in the future. I would not suggest that you have them placed under the muscle. When the implants are placed under the muscle in someone who does strength training, the implants are pushed around and are frequently uncomfortable. The most likely reason for suggesting placement under the muscle is to help hide the implant, especially since you have little breast tissue present. You have had the implants over the muscle, and that is what they would be like if you went back to that position.

R.T. Buchanan, MD

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