After my Breast Augmentation my Breasts Are Flat when I Lay Down!? (photo)

Question

I had my breast augmentation in December of 2011. So its almost been 7 months since my surgery!! My right one has dropped and my doctor agreed and we are setting up an appointment in September 2012! But now i have noticed that both look flat when I lay down. Also I though my cleavage would be a lot closer. So I'm a little disappointed but hopfully it can be fixed. I went from a 36b and now wearing 36d. But to me they don't look like d's. I received 375's gummy bear round implants. Also when I flex my right arm my breast indents and it looks deformed. I'm so disappointed. I love them in a bra but I hate them naked. I actually like my breasts more before my surgery!! Can you sugges what happened to my implants. They are gummy bear gel implants and they shouldn't lose there form.

David Shafer, MD, FACS · Answer

Yes, it appears that the pocket for your implants is too wide, so when you lay down, the volume shifts laterally.  To correct this, you may need placement of Alloderm or other acellular dermal product to help narrow and reinforce the pocket. 

	 

	Good Luck.

S. Larry Schlesinger, MD, FACS · Answer

Obviously, your plastic surgeon is the best one to diagnose what is going on with you, especially since he or she has the advantage of a face to face evaluation. That being said, it appears that your breast implants fall too far into your armpits which gives the flat appearance. There are several ways to correct this. My favorite is the placement of ADM (a cellular dermal matrix). This can close the pocket off to armpit and keep your implant from sliding so far to the sides. Also, it would appear to me that your right implant has possibly fallen a little lower than desired. I think it needs to be raised with a technique called a capsulopexy. All plastic surgeons unfortunately find these problems inadvertently occurring, and we all have our techniques for correcting them.

Vincent N. Zubowicz, MD · Answer

The pictures demonstrate an excessively large pocket for you implants. The volume of the implant falls into the lateral extent of the pocket and off the chest wall. If you want this corrected, it will require another operation.. There are different strategies to deal with the problem.

Neil J. Zemmel, MD, FACS · Answer

Thank you for the pictures.  It appears that your PS may have made the pocket to wide so that when you lay down the implants fall to the sides.  It is possible with a revisional surgery to "sew/ stitch" the capsule laterally to close that extra space so your implants do not shift as they do now when you lay down.  I would recommend returning to your PS, and maybe getting a second opinion.  I hope this helps.

	Kindest regards

	Neil J. Zemmel

Darryl J. Blinski, MD · Answer

Thanks for posting the series of photos. In my internet opinion your pocket was over dissected laterally. The indentation on flexion is the pectoralis inferior border attached to the undersurface of the skin that becomes apparent in action. Yes you will need additional revision surgery. In detail a capsularraphy laterally, fat grafts to the pect. border. Seek in person evaluations.

Peter E. Johnson, MD · Answer

Gummy bear implants are very firm, and if the pocket is right the breast will stand up on the chest even when you lay down. Your photos shows some deformation and displacement from a shift within the pocket, and pressure from the muscle. If you love them in a bra, your implants can be adjusted and saved so seeing your surgeon is an important first step.

Tom J. Pousti, MD · Answer

Thank you for your question and pictures.

	Although your plastic surgeon will be in the best position to provide you advice after direct examination, it may be that you are dealing with lateral breast implant displacement when you lie down.  If this is the case, the breast implant position can be corrected using an internal suture technique decreasing the size of the pockets and moving the implants toward the midline.  correcting the position of the breast implants will also serve to better position the nipple/areola complexes on the breast mounds when you lie down. I hope this helps.

C. Bob Basu, MD, MPH, FACS · Answer

If you feel you've lost volume in your augmented breasts, then it is possible your implant(s) may be ruptured and deflated (if you had saline implants). I'm glad you have an appointment scheduled with your PS in September for a formal evaluation. Best of luck.

Dr. Basu

Houston, TX

Dr. Basu

Houston, TX

Richard P. Rand, MD, FACS (retired) · Answer

Gummy bear breast implants are pretty firm so I am surprised how flat you look lying down.  Best to do as you are planning to check back with your doctor.  Make sure to show them this issue.

Brian Howard, MD (retired) · Answer

Unfortunately, it is very difficult to discern much from these photos. However, in any situation you should have your surgeon examine you in person to determine whether a problem exists.  Best wishes!

After my Breast Augmentation my Breasts Are Flat when I Lay Down!? (photo)

Answers (10)

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