8mth post breast aug. went fr a 36b to 36d-dd. the results were and still awesome standing but lying down the breast tends to flatten and shift down twds armpit. I hv natrelle 15-492cc. I don't know is this bottoming out? Is it fixable? Did I do something wrong?
They Are Still Really Nice Standing but Lying Down the Breast Shifts Down and Towards my Underarm. Should I Be Alarmed?
Doctor Answers (17)
Lying Down the Breast Shifts Down and Towards my Underarm.
The easy part of the answer:
- You did nothing wrong
- This is not bottoming out
Without a photo, I can't really tell if this is "normal" or not.
Larger breasts, implanted or not, fall to the side when laying down. If the pocket is too large either by design or by post-surgical stretching, this can be exaggerated and may be bothersome. And if so, this is fixable by tightening the pocket in the operating room.
All the best.
Breast shift laterally when lying down
You have not done anything wrong and this is not bottoming out. Normal large breasts do move laterally when you lie down and it sounds like your breasts are behaving normally. That, of course, depends on how far laterally they move. Off to the side and flattening a bit is normal; moving completely into your armpit is not and that would require surgery to fix as my colleagues have described. You should discuss your concerns with your surgeon. Good luck to you.
Lateral Migration of Breast Implants
It appears that the breast implant pocket is too large or has been stretched by the size of the implant. Although this is not bottoming out, it will require an outpatient surgery to correct. This involves the placement of sutures along this area to prevent the implant from falling into the armpit. It is often reinforced with a dermal substitute to add strength to the repair.
I wish you a safe and healthy recovery.
Paul S. Gill, M.D.
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Breast Pocket Revision
Based on the information given, you are a candidate for Breast Pocket Revision. It appears your breast pockets have stretched, and need internal sutures, or strattice placed inside for reinforcement. Best wishes!
Shifting Implants Lying Down
From your description this is not bottoming out. Some lateral movement is normal with soft implants and an implant pocket of a certain size. Another surgery (to tighten the pocket laterally) should reduce this displacement. But I am not sure you want to do that. You describe the results as "awesome" when you are standing. You might consider accepting the lateral displacement if it doesn't increase further.
Do check with your plastic surgery! Best of luck,
Flattened breasts when lying down
Thank you for your question. This is nothing to be alarmed about. Your implants have migrated too far to the outside of your chestwall and hence the position when you're lying down. This is not truly bottoming out, however surgical correction is warranted. This can be corrected by placing internal sutures to close this region and occasionally using Strattice to strengthen the repair in this region. Please see a board certified plastic surgeon with expertise in this area to help you with this procedure.
Lateral displacement of implants 8 months postop can be improved
You did nothing wrong and your implants are not bottoming out. Laxity of breast tissue, large implants, and/or over-dissection of the outer pocket can contribute to the lateral displacement or shifting of your implants towards your armpits. This condition can be improved. But, unfortunately, it will require another operation involving placement of internal sutures (capsullorrhaphy). Best wishes.
Implants moving to the side when lying down.
This is caused from the capsule being stretched and can easily be fixed with a capsulorrhaphy. I see this occassionaly and it is almost always in slender women that emphasize pectoral exercises. If that is your case, you need to revise your workout to eliminate heavy pec workouts like pushups, butterflys and bench presses. See a trainer.
Stretch deformity following a breast augmentation
The problem is time, weight and gravity. A large implant coupled with soft tissue that can not support the weight of the implant causes the down and out phenomenon. Every woman with implants wants up and in but if the implant can not be supported it will eventually cause this stretch deformity. This can be corrected with a lateral capsuleopexy, in extreme cases a smaller implant may be indicated.
Revise descent with smaller implants
At size 36 each 200 cc's of implant corresponds to 1 cup size change. You went up approximately 2 1/2 cup sizes from a B to a D-DD. However, these implants weigh about 1 lb each and after 8 months your breasts stretched laterally and will stretch inferiorly. These implants are too heavy and I predict further problems. Unfortunately, you have not provided any photographs or stated whether the implants are in front or behind the muscle. I recommend a new technique called Implant Exchange with Mini Ultimate Breast Lift. Using only a circumareola incision it is possible to exchange your implants for smaller ones, 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. Small silicone gel implants placed retro-pectoral look and feel more natural, are more stable long term, less likely to ripple or have complications needing revision.
Gary Horndeski, M.D.