Breast Implants Too Far Apart - Worth a Revision? (photo)

In January, I got Allergan HP implants, one 425 and the other 450. They're a little too far apart and I wanted some opinions as to whether or not a revision is worth it given my anatomy. I am very tall, but very thin with a small ribcage. My breasts were previously this size when I was nursing my daughter, and they never felt so oddly far apart. Without a bra, my implants will literally slide backwards / apart until I have sideboob for half my ribcage. What complications can arise with revision?

Doctor Answers (12)

Implant Displacement After Breast Augmentation

+1

In general, if the operative procedure was done correctly this may be due to your overall natural chest wall anatomy. However, if you have a small or narrow base diameter there may have been some over dissection of your pocket. This can be corrected and revised by repairing and closing off the lateral over dissected area and using smaller implants. However, the relapse rate can be approaching 30-40% in some patients.


Dallas Plastic Surgeon
5.0 out of 5 stars 17 reviews

You need revision

+1

The photographs show you are very thin and have large implants.  425 and 450 cc implants are too large and have extruded inferiorly and laterally.  You would achieve better results with small implants placed higher and a simultaneous lift.  There is a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to exchange the implants, reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant.  Without a revision, you will have progressve inferior and lateral displacement.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 125 reviews

Breast Implants Too Far Apart - Worth a Revision?

+1

         The result standing up is reasonable, and this may not be worth the additional surgery.  There should be some lateral displacement of the implants with time given most people's tissue laxity.  Pocket revision may or may not correct this.  In addition, preoperative anatomy would have to be considered in this evaluation. 

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 203 reviews

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Breast Implants Too Far Apart - Worth a Revision?

+1

Acceptable result! Very hard to correct the lateral displacement issues. Seek a few IN PERSON opinions. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
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Revising implants that slide to far sideways?

+1

As other have mentioned, you can have your pockets adjusted if the movement is driving you crazy.  When this is done in my practice, you are asked to wear a cut out bra for 6-8 weeks 24/7 to minimize any implant pressure on the sutured capsule.  As for having them closer together, realize that its normal to have space between the breasts, perhaps 1-2 cm and if when standing, yours are like this, I would not attempt to make them closer together.

Curtis Wong, MD
Redding Plastic Surgeon
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Breast implants too far apart

+1

The picture help some but are not enough for a complete diagnosis. It sounds like the pockets are too wide. As mentioned in other posts this may be improved by sewing the pocket closed. This works well and is a brief out patient procedure. If the pocket is not open enough along the  center then this would be released to improve the result. At no time however should the true sternal pectoralis muscle be cut as this may lead to synmastia which means one boob touches the other in the mid line. Good Luck!

Gregory Lynam, MD
Richmond Plastic Surgeon
5.0 out of 5 stars 25 reviews

Breast Implants Too Far Apart - Worth a Revision? (photo)

+1

In the standard view (face on standing) the implant appear to be positioned properly, perhaps even a bit too central in terms of the position of the areolas. They extend beyond the chest wall because they are wider than your anatomy allows. \

Options for improvement would include using smaller implants and closiing off the outer pockets, or using full proflle implants which are narrower, but do not appear as natural. 

If ;you like the size, I would discourage revision. I don't think you will achieve what you want.  All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Breast augmentation revision can reposition implants

+1

Thank you for your question and for providing the photographs.  If the implants are sliding off to the side, the pocket needs to be closed to prevent this.  I often do this type of revision surgery and in some cases suture repair is sufficient but sometimes a new pocket is best and in some cases Strattice is helpful.  Another consideration is if the implants are too wide for your chest wall width.  An in-office consultation with a board certified plastic surgeon will provide you with more information and you can discuss your options.  Try to find a plastic surgeon who specializes in breast surgery and performs a significant number of revisions each year.

Hope this helps.

Tracy Pfeifer, MD

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast Implants Too Far Apart - Worth a Revision?

+1

Thank you for your question.  Lateral stitches can be places to keep the implants from sliding laterally when you lay down.  Like any surgery, there are some risks involved.  You should discuss it with your PS and see what they recommend.  Ultimately, you will need to decide if cost and risk of additional surgery is worth it to improve the appearance. 

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 21 reviews

Implants too far apart

+1

Breast implants are a pillow of volume behind your natural breast (in a cosmetic augmentation). The width of the implant should match the width of the base of your breast. If the implants seem too far apart then your breasts were too far apart for your preference and implants cannot solve that without risking contour problems that need revision -- something that is quite difficult if the implant was too wide or malpositioned. 

In the photos your breasts do not look too far apart but it looks like the width of the implant placed was too wide for the width of your breast and therefore doesn't feel or look like it's part of your breast. This occasionally happens when the capsule stretches but is usually because the pocket dissection for the implant was too wide and/or the implant width was too wide. 

There is no simple surgical correction for this problem. It is best to be avoided by not putting in overly large implants. I would add that most large breasts don't look too good when lying on your back. 

 

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

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