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Big Pocket Under Arm After Breast Augmentation

asked 3 years ago by hopeful2009 in lincoln ne usa
Latest answer by Jason R. Hess, MD
Question viewed 4,033 times
Tags: under arms, under muscle, pocket

I have Saline implants under the muscle and my right implant has always been a little off to the right. If I flex my chest muscles, my right implant goes under my arm. When laying on my back, it almost touches the bed. About the 4th day I had them, I was trying to shave my under arm and couldn't. There is a big pocket under my arm. Is it possible that it was put under the wrong muscle?

13 answers to Big Pocket Under Arm After Breast Augmentation

Please see your treating plastic surgeon

Thanks for your question. I think it is imperative that you continue your follow up with your plastic surgeon. He certainly understands your anatomy and the procedure he/she performed. What you described sounds like the implant has migrated laterally and the “pocket” may be oversized. If revision surgery is required, I usually wait about 90 days. Again, please see your treating plastic surgeon to discuss your concerns! I hope this helps to explain your concerns.... more

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Breast implant pocket

In order to achieve symmetry and excellent result, dissection in the retropectoral plane must be precise. When the pocket is over extended laterally or inferiorly, the implant will be displaced into the armpit or beneath the breast. It sounds like the pocket was dissected too far laterally in this case. Surgical repair would require a capsulorhaphy. This means suture of the pocket back down to the chest wall.

Jason R. Hess, MD
San Diego Plastic Surgeon

Pocket after breast implants

If you have an over extended pocket with implants fallinf off your chest, you may need a revision to perform a pocket adjustment or what is called a capsulorrhaphy.

Steven Wallach, MD
Manhattan Plastic Surgeon

You need revision of breast augmentation pocket.

Hi. When your breast implants were put in, the right pocket was made too large to the side. So the implant slides under your arm. You need a revision to close off the outer lateral part of the implant pocket.

George J. Beraka, MD
Manhattan Plastic Surgeon

Not likely.

Without getting too technical or boring, the muscle (pectoralis major) is a large fan shaped muscle overlying the anterior chest. It attaches to the upper arm and helps move it. When the implant is placed under this muscle, it must first be lifted off of the ribs and a "pocket created" for the implant to reside. What it sounds like to me is that the dissection was carried out too far laterally, and as a result, gravity or muscle action causes the implant to displace to your arm pit, or... more

Scott E. Kasden, MD
Dallas Plastic Surgeon

Lateral migration of the implant is a difficult problem

Lateral and inferior migration of the implant is one of the biggest complaints about breast implants surgery. The weak spot, when the implant is placed under the muscle, is the lower outer quadrant. There is no muscle at this point. It is possible to raise a portion of the serratus muscle along the side to give an additional "buffer" to block lateral migration. Time, weight, gravity, muscle activity, physical activity, your anatomy, elasticity of your skin, and shape of your... more

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

Forced pectoralis contraction can shift implant outside

When the implant is placed under the muscle, forced contraction of the pectoralis can shift the implant to the outside. I would discuss this with your surgeon. In the meantime, you may want to consider (after consulting with your surgeon:) 1. Avoid pectoralis contraction: bench press, push-up, or pec deck exercises; 2) Take an underwire bra and cut out the cup so that the breast pops out where the cup used to be and is held in place, so that it does not shift to the outside especially at... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Big pocket under arm can be fixed

From your description, it sounds like the pocket was made too far lateral. By placing a row of internal stitches under the arm and opening the pocket on the inside, the implant will be repositioned to a more natural position. Ask your surgeon.

Robert M. Jensen, MD
Medford Plastic Surgeon

Get back to your surgeon immediately and show him/her

Hopeful, I am assuming that you are very early out from your surgery, in which case you should return to your surgeon post haste. He/she may be able to tape the outer pocket closed to keep your implant pushed to the center of your breast before your permanent capsule develops. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Muscle junction repairs necessary to support the implant

As the other doctors mentioned the pocket for your breast implant was made too large and too far laterally (on the side). The symptoms you describe occur when the junction or attachment of two muscles--the Serratus Anterior Muscle and the Pectoralis Major Muscle--is violated or pulled apart during surgery to place the breast implant. Normally, these two muscles are fused together on the side of the rib cage and prevent the implant from sliding out to the side under your armpit. These muscle... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Your pocket is to wide

Sometimes a saline implant can drift laterally if your chest wall angles outwardly. If you noticed this immediately after surgery when shaving, the pocket was made too wide during the surgery. The only was to improve this is to surgically tighten the lateral pocket with sutures. This is not always as easy as it might seem so be sure the surgeon who does this has lots of experience. Good luck!

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

It requires a surgical procedure to tighten the pocket

Implants that slide off the side of the chest are caused making the pocket too big to begin with or using the muscle too much or having heavy implant that stretch the tissue. When the implants are put under the muscle the weakest part of the pocket is the outer aspect. The creation of the pocket has to be done in a careful manner not to over dissect the outer aspect. If you do too much heavy lifting and contracting of the muscle it will push the implant to the side. And if you have large,... more

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Breast implant pocket modification

In this circumstance, it sounds as though the pocket may extend too far up in its submuscular location. In the early postop period, a compression garment may help with implant positioning and allow migration out of the pocket extension. Beyond that, operative correction may be necessary with exploration and closure of the pocket.