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Can I get silicone breast implants placed under the muscle or do they have to be on top like my current saline ones?

Q:

I had silicone implants 20 years ago, under the muscle. I was having lots of pain and burning in 1990. I was sent for an MRI then informed of a rupture. I had them removed and replaced with saline on top of muscle. I was just in a car accident that caused one of my implants to rupture. Can I get silicone placed under the muscle or does it have to be on top such as my saline ones are currently? Also is it more probable that since I've had to have so many surgeries that my scar tissue will be worse therefore causing encapsulation?

A:

Yes, you certainly can have your saline implants replaced with silicone implants and they can be placed under the muscle. Although there is some additional scar tissue as a result of the previous surgeries, it will probably not have any influence on your risk of developing capsular contracture. The scar tissue that exists can be appropriately managed at the time of your surgery. Be sure to consult a plastic surgeon who is certified by the American Board of Plastic surgery and has experience in breast surgery revisions.

A:

yes you can have the implants placed under the muscle. I believe they look and feel more natural that way. You may require an uplift as under the muscle does not project the same amount. when the implants are switched, normally the capsule is removed and placed in a new pocket so that you do not increase your incidence of contracture. 

A:

Margie,

Thank you for your question.  Most likely you will be able to have new silicone implants placed beneath the muscle.  However that will depend on the opinion of the plastic surgeon whom you see in consultation.

I agree with others that the scar tissue from your previous sub-muscular breast implants most likely will have resolved by now.  However statistics are that a secondary breast augmentation after a previous capsular contraction does carry an increased risk of recurrent capsular contraction.  Again discuss this with the plastic surgeon you consult.

Good luck.

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