I had my breast implants done on the 1/5/2015 and as time goes on they seem to be moving? (Photos)

I've been offered a revision free of change I went to a cosmetic surgen he said all he needs to do is go in and tighten the pockets and the recovery time is a week is he correct I've seen others have this done and they end up worse then be4 I hVw 520 cc in the left 485 in the right high profile the gap between them is to big worse when i lay done the left seems to fall in my arm pit and I get a sharp pain the left on the arm out side and it feels as it could be bottoming out

Doctor Answers 5

I'm not so sure the position of your implants are the whole cause of the problem

 I think the natural conclusion to jump to when a lady with breast implants tells us that her breasts are too low or that the implants seem to be falling to the side or "bottoming out," is to run off to the OR and simply start tightening the capsules and moving the implants with procedures like capsulorrhaphy or placement of acellular dermal matrix, like Strattice or Alloderm, for support.  Sometimes this is the answer, but many times it isn't, and if this alone is done in these cases, it can make your breasts look worse, not better.  I think you may fall into the latter category, and I'll tell you why.  First, though, I have to make the disclaimer that I am offering these comments strictly on the basis of your images and descriptions, and I have not had the opportunity to examine your breasts personally.  This is essential to the formulation of a definitive plan for any breast surgery like this, so my comments are mainly theoretical at this point.  Having said that, it appears to me from your front images that your implants are not "bottomed out," nor are they significantly far to the side in the upright position, rather your breast tissue itself is both ptotic - drooping low - and falling out laterally, or to the side, relative to your implants.  In addition, you have some axillary breast fullness in the front of the armpit which also exacerbates the fullness on the side of the breasts, too.  More about that later.  With regard to the breasts themselves, it must be noted that the nipple and the breast mound, including the implants, have a very specific and special relationship, and to preserve the overall aesthetics of the breasts, this relationship must be preserved.  This starts by understanding exactly what we have here.  We have breast implants and natural breast tissue, including the nipples, existing together, and those things  can behave different from one another, either by natural forces or by a surgeon's hand.  Thus, if the surgeon moves the breast implants in such as way as to throw off this delicate and specific balance, the breasts will not look good.  As I see it right now, your breast implants are more or less in an appropriate position, at least while standing.  The nipples are already slightly low and outside in relation to the implants; ideally, we'd like to see the nipples centered exactly on the breast mounds/implants, or slightly above the horizontal equator of the implant.  If we simply adjust the position of your implants, especially either upward or inward, in a narrowly-focused effort to simply move the implants up or more toward the central cleavage, without a corresponding movement of the nipples and breast tissue, your nipples will be forced even further downward and outward, and this will look much worse.  I also think your breasts are quite asymmetric, and this is mostly due to the different implant sizes, as I can see clearly which one has the larger implant and which is smaller.  I think both implants should be closer to the same size, if not the same in your case.  I hope all of this makes sense to you.  While you may need some form of capsulorrhaphy, or tightening of the capsule, my impression is that you would benefit more from some form of lifting procedure, with an exchange of your implants, and the adjustment of your capsules, and therefore your breast implants, would be accomplished through this process, along with proper repositioning of your tissues and nipples.  As I said above, this is all subject to a proper examination of your breasts, including detailed measurements, but I wouldn’t just jump so quickly on the “capsulorrhaphy bandwagon”  simply because your implants slide laterally when laying down.  I said I would address your axillary breast tissue too, and that can be easily addressed with a little bit of liposuction directly to that area at the time of any procedure on your breasts.  That will also help the contour of your breasts and chest wall significantly.  Give these ideas some thought, and discuss them with your surgeon.  If need be, you can always get a second or third opinion from other surgeons too.  Revisionary surgery is never easy, and it’s something that requires careful thought and planning, and a very individualized approach if one is to achieve the best results possible.  Be sure you consult with only properly certified plastic surgeons in your area, and preferably ones with lots of experience in breast surgery of all kinds, especially revisionary surgery.  Do your homework, and don’t be hasty.  Best of luck.

Implants shifting

Hello, sometimes implants can settle or shift over time.  It sounds at though your plastic surgeon is more than willing to try to address the issue and see if it can be improved.

Implant problems

What do you mean by moving? Do you mean when you use your chest muscles, or when you lie down? Your implants are quite large, which makes revision surgery more difficult and "tightening the pocket" may or nay not help. 

I suggest you ask your surgeon to see some photos of his corrections for similar problems. He/she is doing the right thing by offering to try to help you at no cost.

Regards, Dr Steve Merten

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Revision?

In my experience, in patients with rather larger implants and a fair amount of pendulous breast tissue to begin with, it is not uncommon that with time the implants, in the lying down position, will migrate away from each other towards the side of the chest wall. This is simply do to gravity. Should it bother you, then a simple fix would be to tighten up the side of the capsule and add something that's a little less stretchable than your tissues. In these situations I have had good success with the use of Strattice or Galloflex. Your plastic surgeon and you can go ove with your what the anticipated results might be and whether it's worthwhile for you to go through with this revision. Best of luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 43 reviews

I had my breast implants done on the 1/5/2015 and as time goes on they seem to be moving?

Thank you for your question and photos.

I am sorry to hear about the problem you are experiencing. You demonstrate your concerns nicely. Although some “falling to the side” of breast implants is normal, if this occurs “excessively”, it may be a concern to patients.  This phenomenon is called lateral displacement of the breast implant;  it may be of concern from the visual and the discomfort standpoints. Surgical correction is an option.

Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline.    In my practice, I use  a 2 layered suture technique (capsulorraphy) to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option ( although not usually necessary)  especially if significant implant rippling/palpability is present.

  Exactly what procedure would be required to achieve your goals would be best determined during in-person evaluation.

I hope this (and the attached link) helps. 

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.