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

Its been over a year since my BA. I still would like them larger but that's another matter. When I lay down on my back, my implants fall to the sides of my chest and upward to my armpits. Can I have unintentionally widen out the pockets? Is this fixable? Should I even be concern about this because it's the norm? Can the pockets be made smaller so they don't go where they shouldn't?

Doctor Answers 18

Implants falling to the side

When a patient without implants lies down, her breasts will shift sideways. The question is whether your implant pockets are too large and, if so,should you undergo capsulorraphy. A consultation would be necessary to evaluate whether your condition warrants further surgery. It is unlikely that you did anything to contribute to widening of the pockets.

New York Plastic Surgeon
5.0 out of 5 stars 18 reviews

Implants Falling into the armpit

Yes, this happens to many patients.... yes, it is fixable.  The procedure is called capsulorrhaphy (internal bra) when a surgeon would go in and place permanent sutures to improve the implant placement on the patient's chest wall.  Not all surgeon's do this procedure so please check the experience of the surgeon you go to.  You may be able to increase the implant size at the same time (1 surgical procedure) but without examination, it's difficult to say.  Recovery is key for this procedure as you will need to limit arm movement and lifting for a longer period of time so that the surgical repair heals.

Surgical correction may be needed.

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.

Breast Implant Revision

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.

Implants falling laterally

This can occur from the pocket becoming larger to accommodate the weight of the implant, your muscle stretching, it can also occur if your pocket was dissected to much laterally. There are things you can do to fix that problem. You can tighten the pocket laterally so that the implant does not fall out to your sides. I would replace your implant with a form stable textured implant (gummy bear implant) to decrease the chance of this occurring again.  

Michael A. Fiorillo, MD
New York Plastic Surgeon
5.0 out of 5 stars 66 reviews

Implants drifting into armpit when laying down usually indicates the pocket is overdissected on the side (laterally)

Hello, What you are describing is often the result of a breast implant pocket that has been over dissected laterally (on the side). How much dissection is overdissection can vary but implants sliding into the armpit when laying down is a fairly good indication. This is rarely the result of something the patient has done. The most common source is over dissection of the pocket during surgery. The pocket can be repaired by suturing it to the appropriate amount. All the best, Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 130 reviews

Lateral location of the implants

It is normal for breasts/implants to move to sides when we lay flat.  However, it is not normal to have implants fall off the chest and into the arm pits.  This is due to implants stretching on the implant pocket because of the weight of implants and stretching of the muscle.  This can be fixed with placing sutures laterally to decrease the pocket.  Please talk with your plastic surgeron for limitations of surgery and possible recurrence of the problem. 

This isn't unusual.

What you're experiencing is that the pockets that your implants sit in have stretched a bit to the side allowing your implants to shift over when gravity allows it.  This can be corrected if it really bothers you by closing the lateral pocket (the part that is most to the side.)

Scott E. Newman, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast "flow"

A little movement of the breasts to the sides when you are laying down is normal and natural, but if your implants are sliding that far, it is too much.  One reason may be that the pocket is too large and needs to be reduced.  This is done by placing rows of sutures along the edges to make it smaller.  This is not as easy as it sounds especially if there is a lot of space that needs to be closed up.  Sometimes the sutures don't hold.  More recently the use of acellular dermal grafts have been used to stabilize and strengthen the suture line.  These are made of skin taken from humans or pigs.  All the cells are removed leaving a scaffolding of connective tissue that provides a matrix for your own tissue to grow into.  They are costly, but effective in more difficult cases where the sutures alone have not held.  Be sure to seek a surgeon who can show you photos.  It is also possible that your breasts are too lax and need to be tightened with a lift and/or larger implants.  A good exam is necessary to better help you.  Good luck.

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.5 out of 5 stars 21 reviews

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

Yes you can improve the position by further surgery. It is called an open capsulorraphy. Best to discuss in detail with your surgeon. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.