What's the Procedure for a Breast That Remains Too High?

I have 250 cc implants on over a naturally flat chest. My PS told me my skin was "tight". My right implant looks awesome. My left one was higher than the right from the get-go, firmer and has more upper pole. (This was the smaller breast and is filled a little more to make them match.) After 9 months, it still doesn't rest in my bra, the difference in the upper pole is still very noticeable and it is still visibly higher than the right. What is the typical fix for this problem?

Doctor Answers (16)

You may need capsulectomy

+2

Most likely you have capsular contracture, and may need capsulotomy or capsulectomy to lower the implant.


Panama City Plastic Surgeon
5.0 out of 5 stars 43 reviews

Capsular release is needed

+2

Nine months is sufficient time to allow for the normal settling that occurs after this surgery.  You likely require a release of the capsule that will allow your left implant to reposition downward.  This is not a very painful procedure, and the same incision is used if you had an inframammary incision.  If you had a transaxillary incision this is not possible and you will need a new incision in the inframammary crease (one reason I prefer the inframammary incision to start with).  It is typical for surgeons not to charge a professional fee for this correction.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 33 reviews

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High riding implant

+1

There is a possibility of a high riding implant after a submuscular breast augmentation. The reasons for a high riding implant can be the result of  the implant being placed high, or the patient may have developed capsular contracture. In the first case scenario, the implant usually stays high the first day and then one side descends into its regular position and the other implant stays high. That is a high riding implant; the correction is a surgical repair and lowering of the muscle. The other condition, capsular contracture, usually implants are initially in a good position but one side, sometime after surgery, progressively starts moving upwards. In this situation, a capsular release or capsulectomy needs to be performed. Also, a change of an implant at the same time can performed to repair this condition.

S. Ozan Sozer, MD
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Implant too high

+1

It is always nice to see photos to determine what the problem is. SOmetimes a simple procedure as releasing the capsule in the lower pole in some patients corrects this issue. If your fold was higher on the afected side that is probably why it is higher post-op.

Steven Wallach, MD
Manhattan Plastic Surgeon
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Breast asymmetry after breast augmentation; could be capsular contracture

+1

If you have asymmetry before surgery, you will have asymmetry after surgery. However, if one side is noticeable higher and firmer, this could indicate capsular contracture( excess hard scar tissue around the implant). This is a condition that typically requires surgical correction.

Consult with your plastic surgeon and review your pre-operative photos and determine if a revision is needed.

Best wishes,

Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 134 reviews

What's the Procedure for a Breast That Remains Too High?

+1

All the experts can give your guidance but a posted photo would have helped. My guess is you will need revisional surgery to lower the Right implant. Best of luck. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Fixing a breast implant that is too high

+1

It usually takes an implant about three to six months to settle into position and swelling to resolve.  After that, if it is still too hight the problem may be due to one of several possibilities:

  1. a capsular contracture developed and is preventing the implant from dropping
  2. you may have breast sagging that wasn't addressed during the first surgery
  3. the implant may have been placed too high 

A breast revision is needed to correct the problem by removing or releasing the capsule, lifting the breast or repositioning the implant depending on what the cause is.

Adam Hamawy, MD
Princeton Plastic Surgeon
5.0 out of 5 stars 13 reviews

What to do if one breast remain higher after an augmentation.

+1
There are many reasons for this kind of problem. If one breast was significantly smaller and a larger implant is used on that side, especially when the skin is tight, that side can look harder and higher from the beginning. A capsular contraction could cause the same problem, but this usually comes later. A revision could take care of the problem after one determines the exact cause.

Farhad Rafizadeh, MD
Morristown Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breasy asymmetry

+1

There are several possibilities to consider here and it's hard to say which applies to you without  at least a photo.  They all involve additional surgery on your left breast.  If your left breast was smaller to begin with it was probably a little higher as well.  The skin envelope is smaller and the implant larger so you have a tighter, rounder and higher breast.  The degree of asymmetry you describe seems like more than just that though.  Does the implant move upward in the pocket?  If it does then the implant just didn't settle as much before the capsule became mature enugh to hold it in the high position.  In this case either incision or excision of the lower capsule will allow the implant to sit in a lower position level with the right one.  If you have a capsular  contracture the entire capsule should be excised and ideally the implant replaced.  In these cases the implant sometimes comes to rest lower than the other one. The use of accelular dermal matrices can lend additional support to the tissues ( but they are expensive).   The best thing to do is see your plastic surgeon.  Consider getting a second opinion.  Nine months is long enough to wait for an inevitable revision. 

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.5 out of 5 stars 11 reviews

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.