Is the PS at Fault if my Implants Go to Far Towards/Under Armpits? (photo)

My implants are about 4mths old, When i lay down they move right under my armpit and sit down my ribs low. What can be done and did the PS make the pocket to big? should he fix it at cost?.

Doctor Answers (19)

Large implants falling towards armpit after breast augmentation

+2

Based on your after photos, it does appear as though you have inferior-lateral migration of your breast implants. A before photo is definitely needed to give you a more definitive diagnosis, but some conclusions can be drawn from the following observations:

  • Your augmentation was sub-glandular
  • Your prosthesis are relatively large
  • You appear to have laterally located nipple-areola complexes (NAC) which suggests that your breasts were somewhat far apart to begin with

Given that sub-glandular placement does not support breast prostheses as well as sub-pectoral and that breasts augmentation can amplify underlying characteristic after augmentation (e.g. breasts that laterally drift to the side prior to surgery will laterally drift to the side - or more so if the implant is too large), if your surgeon had placed the prostheses in a more medial position, the result would have been more lateral NAC positioning. In other words, the more the breast mound is pulled in towards the middle (via a capsulorrhaphy), the further out to the side your nipple areola complexes will end up.

I you do decide to have a revision, my recommendations would most likely be:

  • Switch to a sub muscular position (for support)
  • Utilize slightly smaller prostheses (to minimize further stretching of the skin tissue)
  • If recommended, agree to have a lift (to obtain better positioning and remove any sagging)


Albany Plastic Surgeon
5.0 out of 5 stars 110 reviews

Implant pocket may be too big

+1

Hello,

It sounds and looks like your implant pocket is too big on both sides.  This can be repaired by a "capsullorhapy" or repair of the implant pocket/capsule.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 95 reviews

Implants that go to far towards the armpits

+1

There are several reasons why implants may fall too far to the sides when you lie down.  Yes, it is possible that the pockets were made too far laterally, but this should reveal itself very quickly after surgery.  The pockets can be made perfectly, and yet a patient's tissues may stretch over time due to the weight of the implants...the larger the implants and the thinner a patient's tissues, the more likely it is that this may occur.  Post-operative stretching of this nature cannot be controlled by the surgeon, and there is no question that larger, heavy implants have more problems in this regard.  Also, patients who have certain ribcage shapes, such as laterally tipped ribs, will have implants that settle farther apart when the patient is upright, and those patients are at higher risk for implants that stretch the tissues and fall too far to the sides when lying down.  Patients oftentimes do not realize that not everyone can have the result they want if they do not have the anatomy that will cooperate.  Thin tissues, the use of large heavy implants, wide separation between the breasts, constricted breast deformity, ribcage shape...these all effect what result you achieve.  Breast augmentation is not magic, and it is the responsibility of the surgeon to make sure their patients understand what can be controlled and what cannot.

In your case, it appears that you have larger implants, and we do not see a preoperative photo. Again, larger implants will stretch your tissues more over time, especially if you are a slender person with thinner tissues. If your breasts are low on your chest, the implants will be low as well since the bottom of the implant is at the level of the inframammary crease. If you had somewhat sagging breasts that were filled out by the implants, remember that implants do not lift breasts, they just fill them out.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

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Positioning of breast implants

+1

The implants can migrate outwards if the implants are too heavy, if the tissue does not provide enough support and if the pocket has been created too large.

Without seeing a 'before' picture it is difficult to know the exact cause of the problem, but you may need a revision with a smaller/tighter pocket and possibly a lift.

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon
5.0 out of 5 stars 5 reviews

Is the PS at Fault if my Implants Go to Far Towards/Under Armpits? (photo)

+1

Hi Jodyanne.

Your plastic surgeon must place your implants where Mother Nature has placed your breasts and nipples.

Your nipples sit far out in the direction of your sides. Therefore your implants sit out to the sides.  If they did not, and sat close together near the center of your chest, then your nipples would be way out on the outsides of your breasts pointing sideways.

I ALWAYS discuss these issues with my patients before surgery. There is no disappointment when people know exactly what to expect.

Finally, you don't tell us what type of implant you have. You probably know that saline implants are heavier than silicone gel devices and do have more of a tendency to fall out to the side over time.

 

Eric Pugash, MD
Vancouver Plastic Surgeon
5.0 out of 5 stars 53 reviews

Implant position

+1

Many times the pockets become larger due to the poor quality of tissues.  It can also happen with the pockets being created too large.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Did my Plastic Surgeon make the Breast Implant pockets too big?

+1

Hard to assign singular blame when we do not have all the facts and when it is obvious that your result could be due to your choice of large breast implants.

Despite everything you read here and other less reputable websites, there is a finite limit on how large an implant can be squeezed into the average woman's chest. We refer to the LAWS of Physics Gravity, Momentum Inertia as laws because they always occur and do not make exceptions. When you critically look at your chest, you have a narrow flat landing on which the implant can sit facing forward without sliding sideways). By picking implants which are significantly wider than this area, the implant base exceeds the flat area and tips sideways. This would happen even if you lived in a gravitation free environment. Add gravity to this situation and in addition to the wider implant base you now have a gravitational pull inferiorly and to the side caused by the implants resulting in the look you do not like. Bottom line - large implants in a petite feminine sloped chest will do it.

Your options - live with it, put up with it until the implants need to be changed or change it surgically. Correcting it surgically is more involved than the original operation and as a result more expensive.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 62 reviews

Is the PS at Fault if my Implants Go to Far Towards/Under Armpits? (photo)

+1

Very difficult to lay blame to the PS. You have lateral displacement and some bottoming out. Seek second opinions in person from boarded PSs in LA

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Laterally projecting breasts after augmentation

+1

The shape of the normal breast is oftentimes off to the side of the chest when laying down.  The breast was created to fall this way to facilitate nursing.  Some augmented breasts have the same tendency.  In looking at your breast shape it appears that your areolae are pointing outward to some degree.  The augmented breast will do precisely the same thing.  A very full, enlarged breast will accentuate this tendency.

 

Please don't hesitate to ask your Plastic Surgeon if you have any concern about this, however.

Francis (Frank) William Rieger, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 45 reviews

Asymmetric breasts after breast augmentation

+1

Your result is not optimal and you want confirmation that your plastic surgeon did something wrong so he/she will fix the result at a discount. Not knowing what you looked like before surgery or what exactly was done at surgery it is impossible to know what factor(s) contributed to a less than optimal result. Your posted photos show a wide inter-nipple distance with the left nipple further from the midline than the right and a left breast set lower than the right.

I suspect there was some asymmetry before the surgery with a wider than usual internipple distance. These should be addressed by a skin procedure just before or during the placement of breast implants. I do not believe adjustments to the breast implant pockets alone will suffice.

Before undergoing any additional surgery you need to clearly understand what the problem is and what measures can be employed to fix or improve it. Do not proceed without a clear game plan or you will be destined for even more disappointment.

The majority of surgeons will do early revisions after surgery without charging additional surgical fees though you may still have to pay operating room and anesthesia costs.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic 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.