How Do I Know if my Breast Implant Fell out of Its Pocket?

Question

When I lay on my back, one stays up and the other falls towards the armpit. The one that falls towards the armpit, I can move it all around.

Sanjay Grover, MD, FACS · Answer

Patients may sometimes incorrectly feel that their implants have 'fallen out' of their pocket. The implants do not have anywhere else to go. When patients describe this, they are usually affected by an overly large pocket which may allow the implant to move outwards towards the underarm. This can often be corrected with internal sutures or a lateral capsulorraphy.

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  What you are describing is a lateralization of one of your breast implants.  While this is not dangerous or harmful, it is often an annoyance for patients and I would recommend scheduling a followup with your operating surgeon for evaluation and a physical exam.  Should your physical exam determine that you are experiencing a lateralization of your breast implants due to a large breast pocket, this can usually be corrected with a surgical procedure called a lateral capsulorraphy, which is repair of the breast pocket using sutures.  I hope you find this helpful!

Richard J. Bruneteau, MD · Answer

It’s normal
for the female breast to fall laterally when patients lie on their backs.This occurs for a variety of reasons,
including skin laxity and combined effects of gravity and a sloping chest wall.
It’s not normal for breast implants
to fall into the armpit following breast augmentation.When this situation occurs in the immediate
postoperative period, the most likely cause is over-dissection of the breast
implant pocket.When this situation
occurs late in the postoperative course, stretching of the implant pocket is
the most likely cause.Regardless of the cause, this type of
severe lateral implant displacement requires surgical correction.In most cases, this requires a procedure
known as a capsulorrhaphy.This
operative procedure utilizes sutures to decrease the size of the lateral breast
implant pocket and shift the implant in an inward direction.This procedure is associated with high
success rates and high levels of patient satisfaction.If you’re concerned about implant
position, consultation with your plastic surgeon is appropriate.Your surgeon should be able to formulate a
treatment plan that addresses your concerns.

Steven Wallach, MD · Answer

If the pocket is too large the implant will move around like you describe. You may need a capsulorrhaphy or correction of the capsule to keep the implant in the right place.

T.Y. Steven Ip, MD, FACS · Answer

There are two schools of thought in managing breast implants after surgery. The first is to avoid aggressively massaging the breast implants, and thus keeping the breast pocket unchanged. The second is to aggressively massage the breast implants, and thus keeping the breast implant pockets a little larger. 
If the implant pocket is tighter, the implants will sit more upright . However, longer term you can have a potential higher incidence of capsular contracture. If you keep the implant pocket larger, there is a lower incidence of capsular contracture. However, the implants may be more mobile. Regardless, if your breast implants feel like they are too mobile and are migrating to your armpits, you can easily correct the issue by applying some internal sutures to re-tighten the breast pocket.

Tom J. Pousti, MD · Answer

Sometimes, when implants fall into the armpit, there may be an indication for revisionary breast surgery to internally suture that breast pocket, so that the implant stays in place. You can choose to have this revisionary surgery if the implant placement bothers you.

How Do I Know if my Breast Implant Fell out of Its Pocket?

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