6 mos.ago, I had 371cc silicone implants placed. Now my implants seem to be widely spaced-the right more so than the left. My surgeon has told me that he can remove the implants, put stitches into the lateral sides of the pockets to move them closer together and reinsert them. He said he would also like to move my right nipple upward to align with the left side (although I'm really not interested in that). I would like to have more cleavage-should I have this done? How long to heal?
Should I Have my Breast Implants Moved Closer to Midline? (photo)
Doctor Answers (13)
Do not move your implants toward the midline
In this case, do not move your implants toward the midline. Although it is possible to move an implant to the left or right by suturing the implant pocket, implants should be centered underneath the breast mound and nipple-areolar complex. If you move your current implants too far medially in order to achieve more cleavage, you will be creating implant malposition. You may be a candidate for a wider based implant to help fill in the medial breast tissue.
Evening Out the Girls
It would be nice to see a before photo because you may naturally have wide set breasts. If this is the case then moving them closer may not be possible. If the your breasts were closer and now have migrated outward then surgery would be helpful.
Move Implants Closer to Midline
Moving your implants closer to the midline may not last long if they are under the muscle as they have a tendency to move to the side. If they are above the muscle, it may last. However, the trade off is that your nipples may point more to the side as they will not be in the center of the implant. You should consider leaving them as is.
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You do not need surgery
You should look at your before pictures and check the position of the pectoralis muscle origin over the sternum. You have gap in between implants and repositioning the implants will not help. If you move the implants toward center by releasing the pectoralis muscle,you will have nipples directing outward and palpable implants over the middle . The other option is to move the implants above the muscle,but you have thin tissue and your implant will be palpable. I would leave them alone .
Moving breast implants
This is an interesting and challenging case and I found the responses well worth considering.
The problem is usually not the size of the implant in volume (although it can be) and it's not very feasible to "move" an implant. The problem is usually the location/size/characteristics/dimension of the pocket (capsule) around the implant in relation to the implant and the breast above it. The simplest solution on a secondary procedure is to analyze what is the problem, what could reasonably be done about it, and try to keep it simple.
The aesthetic problem here is that the procedure was done well and the implant on the right is properly positioned and matches the width of the breast for a natural look. It is hard to assess the size/volume of the left implant but the problem is that the capsule and therefore the implant is too constricted on the lower-medial side. If the implant volume is appropriate, then the solution is to release the capsule on the lower-medial side and allow the implant to centralize and match the right side better. This will narrow the gap between the breasts a bit. To narrow it further, a wider implant is needed and both sides would have to be replaced. In a round implant this will also increase the upper pole edge/fill and make both breasts look bigger. This can only be done by a modest amount consistent with the tissue give of a non-contracted capsule/pocket. Usually the maximum for this is about 1 1/2 cm increase width for about a half cup increase in size (if the implant is the same forward projection).
Adjusting the left side alone with the same implant is simpler but changing both sides to wider implants (within limits) isn't much more complicated. I would not try to close the pocket down on the lateral side of the left and "move" the implant over.
Breast Augmentation Revision For Cleavage
While your breast augmentation result may not be perfect, there are risks and potential complications from a revision just like the original procedure. Moving implants closer toward the midline is not always easy or stable after it is done so you would have to accept the aesthetic risk of a revision that might not work or be stable long-term. I would find that improving the left breast via more volume and pocket adjustment to try and match the right breast better a more prudent approach. I would not be encouraging to do a revision if the main goal is to try and improve cleavage.
Personally, based on the photos I would leave them alone. It looks like you have a reasonably good result. Your anatomy leaves you with wide cleavage as you can see how the muscle inserts onto the sternum. If anything the left side( right in the photo) looks a bit lateral and smaller. Maybe a slightly wider larger implant on the left would help.
Should I Have my Breast Implants Moved Closer to Midline? (photo)
Thanks for the photos. Additional surgery has risks. But it is your personal decision. I note also size differences in your left appears smaller.
Keep your implants centered within the breast
Some individuals have a wide chest or breast bone and a more widely spaced breast. The breast implant belongs centered within the breast and should fit hand in glove and move with an feel at one with the breast. We feel it would be a mistake to try to move the implants closer to the center of your chest. You could have a broader diameter implant for better cleavage. There are asymmetries of the breast envelope with one nipple relecting this in its lower position, though if it not a concern don't change it. One thing to consider is a slightly fuller implant on the 'lower' side if you feel a volume difference rigth to left, but you should live with your results before you make any decision.
Best of luck, peterejohnsonmd.com
Probably will move laterally again
It appears that your implants are under the muscle, which is probably the correct decision for someone with your slender build. Unfortunately, submuscular implants do displace more laterally, and cannot be placed as close together as subglandular implants. Unless the pockets are very loose on the side, I think trying to simply close the pockets with sutures will fail over time and may also give an unatural pinched in look on the side. What I see mostly in you is breast asymmetry which is almost certainly related to the shape of your breasts prior to the procedure, and could almost be predicted prior to the procedure. Your eft breast is slightly lower, and lateral, and does not have as much tissue towards the middle as the right. I perform a technique I call composite breast augmentation, using fat rafting in combination with implants to improve asymmetries and increase cleavage by adding fat on the medial aspect of the breast. In your case one would add more on the left than on the right.