When I Lay Down my Chest is Flat and Implants Fall to the Outsides - is That Normal?

When a naturally full breasted person lays down the breasts normally move, or "drape" to the sides. However, implants should not move a great deal to the sides. A small amount of movement is fine, but you describe a significant amount of unnatural movement.Whatever the cause (and this is something that you almost certainly did NOT cause), the pocket containing the implant is far too big.This being the case, then you will need to have surgery to internally tighten your pockets so that they are less mobile and don't slide into your armpits when you lay down. This is not a major problem and any experienced plastic surgeon should be able to sort this out for you.Speak to your surgeon about your concerns so they can discuss the surgical details to you.

This is a good question.
The implants go laterally when you lay down because the pocket has
become too large over time. The implants tend to want to go out to the side
when patients lay down because the chest is round and they are sliding off the
chest.

The good news is that this is easily corrected. As you
mention in your question the pocket can be closed with sutures on the inside so
that the implant is in the proper position. I also usually encourage patients
if they have saline implants to switch to silicone implants, as the softer
implants tend to go out laterally less than the firm saline implants do over
time.

Discuss this with your board certified plastic surgeon as
you have options to improve the appearance of your breasts.

Thank you for your question.  It is possible that overtime your breast pocket may expand allowing your implants to fall laterally.  The good news is that while it does require a procedure to correct, this lateralization of your implants is fixable!  Performing a pocket repair would most likely be necessary and involved the placement of permanent sutures to essentially create an internal bra and close the pocket where it has loosened.  This procedure will place your implants back in the correct position and prevent this 'falling' effect when laying down.  At the same time, it is possible to increase or reduce the size of a patients implants.  I would caution you from going too much bigger as you do not want to create extra stress on the newly repaired pockets, but a physical exam would be necessary to say for certain what is and is not advisable.  Please schedule a consultation with a board-certified plastic surgeon who is well-experienced in performing these pocket revision procedures.  Best of luck!

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 the combined effects of
gravity and a sloping chest wall.

It’s
not normal for breast implants to fall into the arm pit following breast
augmentation. When this situation occurs
in the immediate post-operative period, the most likely cause is over
dissection of the breast implant pocket.
When this situation occurs late in the post-operative 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 positional implant malposition, consultation with your
plastic surgeon is appropriate. Your
surgeon should be able to formulate a treatment plan that addresses your
concerns.

There is often a fine line between what is expected or normal postoperative appearance and what is unusual.  All breast tissue and implants will move with different positions (unless there is a lot of hard scar tissue), but the extent of how far is what really matters.  Without an examination, it's difficult to say whether it is "normal" or not - and the real question is whether the movement bothers you.  I would recommend you ask your plastic surgeon to evaluate the position of the implants to give you advice on whether you need (or want) any further surgery.   It is definitely something to discuss if you are considering having larger implants placed, since the pockets can be modified at that time if necessary.

Saline breast implants have a much greater tendency than silicone gel devices to fall to the side when the patient lies down. This 'fall-out' usually develops over a couple of years after surgery.

This is due to the saline implant's greater weight, as well as to its generally thinner scar tissue capsule compared to silicone gel implants.

Also, implants that have been placed under the muscle are subject to the downward and outward push of the pectoralis muscles.

This problem will be more severe as the size of the implant increases.

When I convert patients from saline to gel implants I usually suture the pocket internally to reduce the displacement to the side. A certain amount of recurrence does occur, but there is nearly always significant improvement.

 

 

While this does happen over time because breast implant pockets may enlarge, it seems a bit unfortunate that this happened to you so close to 1 year after your breast augmentation.  The size of the pockets can be reduced and the breast can be reshaped, with the opportunity to maintain more anterior chest wall position of the breast implants with surgical intervention, and I recommend that you see a highly skilled Board Certified Plastic Surgeon to do this work for you.

For your individual situation, it's best to speak with your plastic surgeon. A consultation would be necessary to determine if you would need surgical correction with more dissection of the pocket medially to enhance the cleavage region

It is natural for the breasts to move away from each other, falling to the sides. This is natural anatomy. However, if you think there is excessive movement, then you can speak to your surgeon about fixing the pockets in which the implants sit.

Thank you for the question.  it is normal for natural breasts to fall to the sides when lying on their back.  For implants to fall to the sides, it is not uncommon and could be fixed through capsulorrhaphy.  Best to visit your board-certified plastic surgeon and have your concern assessed.  Best of luck. Dr. Michael Omidi.









An
in-person exam with a board-certified plastic surgeon is the best way to assess
your needs and provide true medical advice.