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Ask Dr. Pelletiere (Illinois) In this forum, you can ask Chicago, Illinois plastic surgeon, Dr. Christopher Pelletiere, questions about breast augmentation and other plastic surgery procedures.

Question about switching breast implants from unders to over the muscle!

Old 10-08-2019, 02:59 PM
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Question about switching breast implants from unders to over the muscle!

Hello Dr. Pelletiere,

I live in IL and will be scheduling an appointment with you as soon has my back injury heals.

5 years ago, I had a BA with saline implants placed underneath the muscle with another surgeon (not you). I am regretting this for many reasons. I am regretting that I had my muscle cut. I feel that it has caused arm weakness and chest weakness when I lift and flex and it feels uncomfortable. It feels unnatural because the muscle is constantly pulling the implants outwards towards my armpits. I also have flex distortion any time I flex my chest muscles or pick something up. I have noticed that my left breast implant has slipped slightly below my muscle... (double bubble) when I raise my arms and now my left breast crease is lower than the right breast. I am very upset and unhappy with my results. This is my second BA. I should of left things alone with my first BA, but I wanted to go bigger and felt that I didn't get the results that I was looking for. I went from 395cc to 525cc saline implant.

So now I am reading more about women who chose to have their implants placed over the muscle. I am very interested in this since I have plenty of tissue to go over the muscle. I believe this would solve all the issues that I am having above. However, it does increase the risk of CC, so I am nervous about that.

Do you have experience switching the breast implant's location from under the muscle to over the muscle? How much would this increase the CC risk? Does it also increase bread loafing? My cleavage is pretty close now.
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Old 10-12-2019, 07:28 AM
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Converting to Subglandular

Converting to above the muscle is pretty straightforward from a technical standpoint, but does have its own issues. Contracture rates are definitely higher in every study unless you use a textured device, but you have to be willing to accept the ALCL risk. I use the Mentor microtextured devices when needed and we think that the ALCL risks should be about 1:75,000 in those patients. You also run a higher risk of settling more over time. This is not to say that it shouldn’t be done. It is more to give you the facts. The best thing to do is to come in for a consultation and see what we can figure out with regards to the best plan for you.
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