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Breast Implant Revision
If I opt to get a 3rd Breast Augmentation, can my implants be put completely behind the muscle this time?
Under the muscle implants usually aren't fully under the muscle. Very commonly, a portion of the inferior lateral implant is exposed. The science behind decreased capsular contracture for under the muscle placement has to do with isolating the implant from the ductal breast tissue which natively has bacteria. Peri-areolar augmentations have a slightly higher chance of capsular contracture when a funnel is not used to place the implants even in a sub muscular position. The real issue is what can be done to reduce your chance of recurrent capsular contracture. Submuscular placement of the implants is a good step but you should discuss dermal matrix placement as well as a preventative measure for recurrence.
Clinical Context
Placing an implant under the chest muscle can lower the risk of capsular contracture because it keeps the implant farther from breast duct tissue, which naturally carries bacteria that can settle on an implant surface and trigger scar tissue. Using an insertion funnel during surgery, especially with periareolar incisions, helps limit this contact further. Acellular dermal matrix adds another layer of separation and may help reduce the chance of contracture recurring after a previous case.
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