Breast Implants: Large Pocket vs. Small Pocket?

I recently noticed that surgeons have different preferences when it comes to breast implant pocket size. Observing photos, I notice that generally the implant sits quite high post surgery and drops over over time. My friend got implants and they were never high. They looked great from day 1. Her surgeon said his patients don't need to wait for implants to drop. He mentioned that other surgeons create a larger pocket. Why would a surgeon prefer a small pocket over a large one?

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12 Doctor Answers | Asked by CanadianGirl26 in Vancouver, BC

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Breast augmentation

There are many factors that determine how your breasts will look right after surgery. If you have small breasts with tight skin , aren't very tall or if you are going fairly large it is more likely you will have a high type of look. If your breasts are at least a B cup or greater , if they are a little loose from having children , if you are tall and a lot of space on your rib cage , or if you aren't going very large they might look very natural right from the beginning.... more

Pocket size in breast implant augmentation

This is a very perceptive question and is one of the keys to understanding how surgery, implants, and results work. There are actually two issues. One is pocket size relative to the implant size and the other is the position of the implant relative to the breast. If you think of it as an orthopedic surgeon putting in a hip implant it's easier to understand. The "pocket" for the implant has to be precise and the size of the implant has to exactly fit the... more

Size of pocket

The size of pocket is based on the size of the implant, the type of the implant and the experience of the surgeon. Long term follow-up is so important so a surgeon can get a good idea of the long term outcome of his/her approach. I always encourange my patients to come back yearly so I can get this followup. My current approach with smooth implants is to make the pocket just a little bigger than the implant and get the patient massaging the breasts within a week. ... more

Pocket Control in Breast Augmentation Matters

Dear CanadianGirl26, In breast augmentation, an important part of the surgeon's job is to choose a suitable breast implant and to create the proper space (or "pocket") for that implant to sit in. In general, the pocket should be neither too small (which can distort or constrict the implant) nor too large (which can lead to implant migration or malposition). The pocket needs to be "just right," which is why choosing a skilled surgeon is important. In general, most... more

Breast Implant Pocket Position

In many breast augmentation patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition,... more

Michael Law, MD

17 reviews

Raleigh-Durham Plastic Surgeon

michaellawmd.com

It should be about the size of the implant

The pocket should be created to be about the size of the implant - too large a pocket will let the implants fall to the side when you lay down, too small and the implant will get squished and look funny at first. Most people's implants look high at first but sometimes the inflammatory reaction is less and they don't look too high - I find this happens more with silicone implants. This may be what was going on with your friend.

Breast Implants - High Post-Op, Need to Settle

Hi CanadianGirl26 in Vancouver, BC, As always, there are many different answers to a question such as this. But I would say that, in general, most surgeons make the pocket approximately the correct size and location to fit the desired implant, and centered under the nipple. Years ago, when it was felt that implants needed to be massaged around a larger pocket to prevent capsular contracture, surgeons would be more likely to create a large pocket to begin with. With... more

Breast pocket size and breast augmentation

Breast pocket size is determined by a number of factors - the size of the patient's chest, the size of the implants being used, the elasticity of the skin and breast tissue, etc. In this regard, most plastic surgeons adopt the Goldilocks approach - not too big and not too small, but just right. Given the number of variables, there is no exact or "right" answer. If one has tight tissues and/or small breast and chooses large implants they will be tighter... more

Implant position

Implants change position a bit with time. They can initially be pulled up by the muscle from spasm after srugery. It really has nothing to do with the pocket size because under the muscle, the implants can be "pistoned" by the muscle which can cause the pocket to open up in the natural plane.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Implant position

Breast implants always drop over time unless they are held up by a submuscular position. "High" implants can be due to post-surgical swelling that is more prominent up on top and resolved w time. "High" implants are normal when I perform the transaxillary approach as the pectoral muscle take some time to relax and the implant descends a little. When implants are place above the muscle they ALWAYS drop over time and I slightly overcorrect for this by... more

The pocket should match the implant size

There should be no need for rappind and pushing the implant down . The implant should fit the pocket ...

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Correct breast implant pocket size

We believe that the implant pocket should match the size of the breast implant, and be centered on the nipple. The lower portion of the breast, fold and skin envelope often must relax to accommodate the implant, and settling in. Breast implants should not have to drop, And the breast band is designed to hold the implant into the bottom of the pocket until the skin relaxes and the is a blending of the breast and the implant, a marriage between the two. Lots of ideas out there but this works... more