Why does my right breast look square from side while laying down? (photos)

I have a rather large space between my breasts and my right nipple is always popping out of my bras. Algerian 410 anatomical, 350 cc with lollipop lift 3 years ago. I can feel right breast off center and it is now rubbing on my rib. It also looks square and falls under arm pit when I lay down. I am also unhappy with the uneven shape of my areoles. If I need more surgery I would like to go larger. I'm 44 and the type of implant feels to hard under my soft breast tissue. Any suggestions appreciated.

Doctor Answers 6

Needs a revision

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 From the photographs, it appears to me that the left breast has bottomed out fairly significantly compared to the right. The side of the breast capsules has significantly stretched such that when laying down they migrate out and away. The correction for this, in my opinion, would be to redo the lift, cinch up the bottom capsule on the left and on the sides on both breasts. We call this capsulorraphy. I would switch you out from a 410 to a softer silicone gel implant from a company called Sientra. If you want to go larger, and have already migrated down and out at 350 mL I would suggest that you add an ADM like Strattice to keep this from happening again. You might want to consult with a board-certified plastic surgeon with experience in revision of breast augmentation. Good luck.

Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Why does my right breast look square from side while laying down?

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Thank you for your question and photographs.  It appears that you are suffering from implant malposition with your implant have fallen too low on your chest and too far out to your side. This is causing an elevation to your nipple when standing and the square appearance to your breast while laying down.  See a plastic surgeon with experience in breast implant revision cases to help reposition your implant.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Why does my right breast look square.

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With thin breast tissue and a form stable implant like the 410 you can see the footprint of the implant and the breast might feel stiff with little flow in the breast. Also your lift is a bit too much if the nipple peaks out of the top of your bra. A soft moderate profile gel and a revision of the lift with an anchor pattern might bring down the nipple and improve things.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

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Bottoming Out / Internal Bra Repair

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Good afternoon!

You do have a significant amount of bottoming out on the right side, lateral displacement on both sides, and this is what gives you the flatness and the huge gap when you lay down. basically your pockets are waaaaay too big, and your implants can slide all over your chest wall depending on what position you are in.

The correct repair is the Internal Bra, my strong permanent internal suturing technique which corrects your bottoming out and lateral displacement. This is the most common type of revision I perform, 5-6 times a week- it works and it lasts!

I have attached a link to my Internal Bra / Breast Augmentation Revision photo gallery for your review- hope it helps!

Revision options

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Thank you for the question and photos. It sounds like you have a number of concerns you will want to address if considering a revision. I recommend that you meet with a board certified Plastic Surgeon in person so that they can examine you and discuss what you would kike to change in detail. They will make suggestions for surgical/implant options and any revision to the pocket which you may need. 

All the best 


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It looks like you might benefit from a revision.  One side might have bottomed out, and the lateral displacement may be corrected with a pocket revision. Firmness may be related to the implant type.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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.