Why do my implants fall to the side? (Photo)

Question

I had breast augmentation 3 months ago going on 4 why are they falling to the sise when i lay down?

Vincent N. Zubowicz, MD · Answer

Press will naturally fall toward the axilla when one lies down because of gravity. When excessive it may be the result of the pocket dissected for the implant extending to four laterally. Physical examination would be necessary to evaluate this. The other thing is that a sub pectoral implant will be pushed laterally by the muscle and this may play a role in the phenomenon.

Daniel Barrett, MD · Answer

Dear fdelarosa14,I get this problem all of the time.  Typically, its from women who went with high profile implants.  This is a problem because while they project more, they are narrow at the base and can have widening effect on cleavage.  The second most common problem is incomplete release of the pectoralis muscle medially. Many surgeons don't take the time to make this right.  If you're not happy with your results I would suggest you to discuss it with your plastic surgeon. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Edwin C. Pound, III, MD · Answer

Your chest muscle crosses each side of your chest at an angle from your shoulder to your chest bone.  Because of this, it does not offer much support out to the side.  If the pocket is over-dissected to the side, or if your tissues are simply weak out to the side, then the implant can slide out into your armpit when you are lying down.  This can be corrected by reinforcing the outer half of the pocket using sutures plus/minus the addition of material such as Galaflex, Alloderm, FlexHD, etc. to add additional strength.

Chet Mays, MD · Answer

Thanks for your question.  Implant position can fall to the side or migrate laterally for a few reasons. Your chest wall can be cause for position change of implant or breast when you lie down. If your chest wall slopes, then there is an increase risk of the implants sliding to the side. Another reason can be size of the pocket that surrounds your implant.  There are surgical procedures that can improve position of your breast that your surgeon can discuss with you.   Best of luck.

Tim Sayed, MD, MBA, FACS · Answer

Natural breasts fall to the side when a patient lies down, so it's not unusual to see an augmented breast do the same. However, if the implants are sliding to the sides more than the native breast or it is causing a hollowing near the breast bone, then it may be that:1. Your implants may be too narrow for your chest wall and/or2. Your pocket may be too large toward the sides for the implants selected.Correction of these issues can include upsizing implants, changing implant styles, pocket revision/capsulorrhaphy, and other options, depending on the findings on physical exam during consultation. It also appears you have had a lift or reduction, which may mean that you have loose breast skin that is easily stretched and needs to be revised to tighten the envelope further.

Marc J. Salzman, MD, FACS (retired) · Answer

Unfortunately, gravity is unrelenting and most women have chest walls that slope downward. The weight of the breast and implant in your case can overwhelm the ability of your capsule to hold it towards the center. The way to adjust this is to add a material that does not stretch to the side of the implant capsule. Preferably I like to use Galaflex in these situations. Your plastic surgeon will be your best resource here. Hope that's helpful.

Why do my implants fall to the side? (Photo)

Answers (6)

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