Dear Cherabine:
I agree with Drs. Rand and Goldstein for most patients who have a significant drift of the breast complex (including the nipple/areolar complex - NAC) over the implant. Sometimes the appearance of drift may be from a subtle capsular contracture which has elevated the implant above the NAC giving it the 'snoopy' look.
Interestingly, this effect is the principle behind the 'internal mastopexy' which leaves no external scars, and is a type of 'gathering' or 'plication' of the central and superior portion of the internal capsule towards the collar bone with a purse-string suture providing a mild 1 - 2 cm 'lift' of the NAC.
I had a patient with a 20 yr textured saline implant that 'didn't move' even though it was above the muscle, and her NAC had drifted below the central mound Dr. Rand refers to. All I had to do is re-dissect the anterior portion of the capsule surrounding the prosthesis to 'recreate' the pocket, place the pursestring sutures and add the new smooth cohesive gel prosthesis - she was a different woman in less than 2 hrs!
When you combine this subtle 'lift' with a slight lowering of the inframmamary crease (IMC) and a slightly wider, low profile, smooth surface, new gel implant design you can maintain your current texture while 're-aligning' your breasts to a more youthful position for years to come - without any new scars!
Dr. C
