10 months post op, breasts appear to be bottoming out and very far apart. Is there a fix? (photos)

I had 425 CC's submuscular in November 2015 by Dr Hedden. They looked great but recently I've noticed a difference. I can feel the actual implant at the bottom of my breasts. Is this normal? They're now spaced very far apart and I have no cleavage, even in a push up bra. Theyre basically in my armpits. They're also not full at the top anymore, all of the volume has gone to the bottom of the breast. I know that breasts drop after surgery, but this is a bit much. What can be done to fix this?

Doctor Answers 5

Bottoming Out of Implants

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Hi ecs

I would tend to agree with your diagnosis.  This, unfortunately can occur after BAM.  This results from the dissection needed to create the pockets.  Sometimes the pocket isn't as strong as it should be and due to the weakness, the implant may drop lower than desirable.  This is manifested by an increase in the distance between the nipple and the fold (where underwire sits), with loss of upper pole fullness.

If the implants are now under your arms, this indicates that the pockets have stretched laterally as well.

You need to go to your doctor and discuss the situation with him.  You will need to have the pocket adjusted to move the implants upward and inward.  The procedure is called a capsulhorrhapy (capsule revision).  This is usually done by suturing the capsule along the lateral and inferior borders and is usually very successful.

All the best to you!


Breasts appear to be bottoming out

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Thank you for your question. It will be helpful to compare with pre op pictures before we comment. If you feel implant in arm pit area more than usual it mat be pocket issue.  Anyway you need a physical exam and evaluation by your PS to determine the cause. Good luck

Implant Position

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Great Question! It is hard to tell what exactly is going on without seeing your before pictures as well. It is very normal to feel the edge of your implant at the bottom of your breasts. If your implants are moving into your arm pit when you take your bra off or lay flat this could be a pocket issue. Sometimes patient's pockets that their implants sit in stretch out and cause too much movement of the implant. This can be fixed with a surgical procedure called a capsulorrhaphy. A capsulorrhaphy will tighten your pocket- which will make your implant not move into your arm pit and also help with your cleavage issues. I believe if your PS did a capsulorrhaphy on both of your breasts you wouldn't feel bottom heavy and it will help with cleavage and not going into your arm pit. Good Luck!

Ed Breazeale, Jr., MD
Knoxville Plastic Surgeon
4.5 out of 5 stars 15 reviews

Implant Malposition

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While it is normal for implants to drop and upper fullness to decrease, noting such a change at almost a year out is unexpected. As well, it is normal to be able to feel the implant through the skin at the lower poles where the breast tissue is the thinnest, but if you note the position of the incision and crease has changed recently then you may have a malposition issue. It would be best to evaluate these concerns in person, with your Plastic Surgeon as they know your situation the best.

Take care

Implant dropping

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If you want to raise that right implant and bring it more toward the midline, it would require another operation and some work on the pocket, often including alloderm or some form of dermal matrix like used in breast reconstruction.

Tyler C. Street, MD
Napa Plastic Surgeon
5.0 out of 5 stars 4 reviews

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