I have textured submuscular implants. 3 months post op and altho they have healed well. I find that they dont move. I find that I cannot push them together at all and instead are left with 2 wide apart humps which I find embarrasing. Also most of my implant is stuck under my arm pit. Should I ask to be switch to low smooth which was my prefrance before but was told that it isn't done in the uk, because it isn't as good as textured. even tho I was shown smooth at my consoltation.
Far Apart Implants - Should I Ask for a Revision?
Doctor Answers 11
I am not a fan of textured implants becuase they do not move more naturally like smooth implants usually do. Cleavage is based upon your anatomy.
Asking for revision?
If you are unhappy with the results of your surgery, you should discuss this with your plastic surgeon. Although there are limits to what can be achieved with breast implants, the best thing to do is have an open and honest discussion with your surgeon.
From your pre-operative pictures, it looks like there should be no problem making your implants closer to the middle to achieve better cleavage. You would need a revision surgery to repair your current problem - and you may need to use a dermal matrix (alloderm) to help keep your implants from falling to the sides and laying underneath your armpits like they do now. Good luck!
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Breast implant revision
You could improve the look and feel of your result by going back in and widening the pocket toward the midline and usind a wider smooth walled implant. The lateral pocket might also need to be closed up a little to keep the implants from wanting to fall back out there. I don't know what incision you had but this time you need one in the crease.
New breast implants look far apart - revision needed?
Based on the before and after photos you shared, the reason why your implants appear to be farther apart than you wish is that your pre-operative photos show your nipple areola to be situated slightly lateral to the meridian (center). It also appears that you had a relatively small prostheses which makes it more difficult to achieve a medial cleavage. That said, if the prosthesis had been placed further to the inside, then the nipple areola would not have been situated over the prosthesis and would not have looked natural.
The difference between the textured and the smooth prosthesis is relatively minor in regards to 'feel' and does not effect the overall positioning or size of the implant. If you had gone with a larger implant, it would have given you a bit more cleavage but at the expense of having a bit more fullness towards the axilla.
All in all your plastic surgeon did a very appropriate placement based on your pre-operative appearance.
Repositioning breast implants
If you are unhappy with the appearance of your implants, you should discuss your concerns with your plastic surgeon. There are limits to what can be achieved with implants alone, because implants should be centered under the breast mound and nipples. Your anatomy, such as separation between your nipples and where the breasts are located on the chest wall, cannot be changed with breast augmentation surgery.
Implant mal-position may be due to capsular contracture
If you are unhappy with the appearance of your implants, then you may want to consider having them revised. Certainly textured implants are less likely to move around than are smooth shelled implants. However, in this particular case modification of the pocket and breast capsule will be required. Further, if they are very hard, it is possible that you are developing capsular contracture of the implants which is preventing them from sitting in the correct position.
Proper Position of Breast Implants
The ideal position of breast implants is centrally behind both the breast as well as the nipple and areola. Every womans nipples are at slightly different locations (high, low, toward middle or side) - thus the placement of the implant should be guided by your anatomy. If the nipple is too far to one side then the implant needs to be centered on this location often leaving a large gap between the breasts. If the implant is placed more toward the center, the nipple can be located on the side of the implant - making it more obvious. Wider implants can help as well as a procedure that moves the nipple more toward the ideal center of the breast. Also, textured implants tend to become more "locked" in place and relating to the textured surface. This makes them less mobile and fixed in place.
Best of luck
Vincent Marin, MD, FACS
Breast Implants appear wide apart
Hello and thank you for the question.
In regards to your concern and from examining your photographs, it appears that your implants are fairly well positioned. The limiting factor to attaining medialized implants is, as my colleague suggests, the point of attachment of your pectoralis muscle onto the sternum, as well as the natural width of the sternum. A naturally wider sternum will lend to implants that appear "further apart". While I don't have the liberty of knowing what type of implant was used in your case, you may also benefit from a slightly wider implant. This is something you would need to discuss with your surgeon.
Best of luck,
Glenn Vallecillos, M.D., F.A.C.S.
Implants wide apart
From your picture, it looks as though your implants are properly positioned behind your breast tissue. The line where your chest muscle attaches to your breast bone is usually the limit of how close together your implants can be. If you try to move them closer, you may see the edge of the implants through the skin, even with silicone. Also, as it has been noted, your nipples may then point outward too much. You could discuss replacement with a wider (lower profile) implant to maximize the cleavage. Also, smooth implants are more mobile, so you should again discuss this with your surgeon.
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