My right implant didn't drop - what could it be?

Question

I had my surgery back in March 2023. I am noticing that my right implant didn't drop as much as my left one. Both breasts are soft and no pain at all.. my right side just looks a bit different. It was like this since I had surgery. What could it be??

Azita Madjidi, MD, MS, FACS · Answer

There could be several reasons why the right is higher. One is the technique: submuscular implants tend to stay high. If the pockets were made at a different level, implant placement will be different. The other is if implants are different, they shape the breasts differently. Also if your right breast is higher on your chest, then the implant will seem higher. Capsular contracture is another reason but it usually is happens months after surgery. Best is to ask your surgeon who can answer most of these questions.

J. Timothy Katzen, MD, FACS · Answer

Hello Pinky Dreams 112 in Decatur,
Thank you for reaching out with your concerns about your right breast implant. Based on your history and photos, it seems that the issue of the implant not dropping might be attributed to the incomplete release of the pectoralis major muscle during your initial surgery. This incomplete release can hinder the implant's ability to settle into its intended position, which could explain the asymmetry you're experiencing.
Given that you're over a year post-surgery and there are no signs of capsular contracture or pain, it's unlikely that the implant will settle on its own at this stage. Therefore, a surgical revision might be necessary. This revision would involve further releasing the pectoralis major muscle, allowing the implant to drop into a more natural position.
This corrective procedure is usually performed under general anesthesia and may take around two hours. It's essential to discuss your options thoroughly with your plastic surgeon, considering all the risks and benefits involved in a revision surgery.
I hope this information provides some clarity on your situation and assists you in making an informed decision moving forward. Please consult with your surgeon to explore the best course of action for your specific case.
Sincerely,
Dr. Katzen

Keshav Magge, MD · Answer

Thank you for your question.  This can happen on occasion.  Sometimes if the muscle was not completely transected it could happen. Sometimes the tissue just doesn't stretch or relax so the implant doesn't drop.  This requires going back in and releasing the capsule inferiorly to get the implant in a better position.  I would recommend speaking to your plastic surgeon.  All the best,

Daniel Barrett, MD · Answer

Dear Pinky dreams 112,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Brian K. Reedy, MD · Answer

Thank you for your photos and question.  Have you been doing massages to the breast? I recommend you consult with your surgeon and have them instruct you on doing some gentle downward massage or possibly talk about lowering that pole on the one side to release the implant. You also want to rule out a capsular contractor.

Dana Goldberg, MD · Answer

A high riding implant could represent pre-existing asymmetry (many patients have one breast or pectoral muscle that is higher on their chest, only most don't notice it until after surgery). This could also represent poor positioning in surgery or early onset capsular contracture (although that sounds less likely based on your noticing it early on and not having tightness.

I would discuss the possibility of revision with your surgeon to see if removing or scoring a portion of the capsule and lowering the implant is possible.

I would discuss the possibility of revision with your surgeon to see if removing or scoring a portion of the capsule and lowering the implant is possible.

Zoran Potparic, MD · Answer

You do have some asymmetry, one side being higher, fuller and also displaced laterally. These may be signs of breast contracture and need to be evaluated and discussed with your surgeon. Several things can be considered if the deformity is not due to contracture; implant repositioning using capsulotomies, fat grafting to camouflage deformity and improve symmetry. I think this should be discussed with your surgeon based on in-person evaluation and findings. Good luck.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  A few possibilities exist - if the appearance has "worsened" with time providing the upper breast fullness, and the breast has hardened, you may have a capsular contracture.  If the situation has been the same since surgery, the surgical pocket created may have not been sufficiently large for the implant placed.  I would seek out in-person consultations for a diagnosis and treatment plan as unfortunately surgery will be required to improve your current outcome.

Camille Cash, MD · Answer

There can be several reasons for the implant not dropping.  It can range from the way the implants were placed to capsular contracture.  It is best to visit with your surgeon for an evaluation to determine the appropriate treatment based on the underlying cause.

Connie Hiers, MD, FACS · Answer

You have a capsule that is not letting the implant drop. You can try oral Accolate and external ultrasound treatments to see if the capsule can stretch, or surgery.

My right implant didn't drop - what could it be?

Answers (13)

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