Have my implants come out of their pocket? What are my options? 2 years post breast aug (photos)

Question

I had a breast lift and augm. In late 2020. Since that time I have had issues with the breast implants. I have gone in for multiple consults with the original surgeon and was told that the settling was normal. However, I do not think this is normal. When I lie down, the implant itself almost goes into my armpit, and when I am standing the breast no longer have volume and I can feel the entire implant in the lower part of my breast. I am not sure what to do. The original surgeon is no help.

Gerald Minniti, MD, FACS · Answer

It is not uncommon seeing what you are experiencing. There is nothing terribly 'wrong' per se, but what you are experiencing is excessive lower pole stretch and lateralization of your implants. I'm sure a physical examination would confirm that your implants are very soft and mobile. You body's scar capsule formed with a lot of elasticity and stretch, putting the full force of the implants weight on your breast tissue, which in turn expanded and led to expansion of your scar capsule. It's a 'vicious cycle' that leads to your result. Although you have plenty of upper pole fullness, I can understand if you wanted more of it and also had implants that didn't lateralize when you lie down. You would have to way the risks and benefits of a surgery to 'tighten things up' again, which would include the use of resorbable mesh to reinforce your scar capsules.

Farbod Esmailian, MD · Answer

It sounds like you have lateral displacement of your implants which is fixed by performing tightening of the pocket laterally by a capsulorrhaphy. As far as the implant dropping in the bottom of your breasts, it does appear that your skin has stretched out in the lower pole. The solution, difficult to tell by photos, would be either to redo your lift and/or placing a more cohesive silicone gel implant or over filled saline to give you the upper pole that you may be missing.

Hope that helps. Make sure you see a board certified plastic surgeon that has experience in breast revision surgery.

Hope that helps.  Make sure you see a board certified plastic surgeon that has experience in breast revision surgery.

Daniel Barrett, MD · Answer

Dear megeb81,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Your large implants have stretched your tissue and do move more in their pockets.  Your pockets could be made smaller and you might need mesh to help hold them in position.

Douglas Taranow, DO, FACOS · Answer

Your implants have "not come out of the pocket", but rather have settled and bottomed out due to their size and weight.  You require a breast revision, with plication (suturing) of the capsules to elevate the the implants and close the lateral pocket so the implants cannot travel towards the armpit.  In some cases, a bolster like fabric (ADM-acellular dermal matrix may be used to further support the weight of the larger implants/breasts.  Another breast lift (mastopexy) may also be required.
Best wishes.
Dr. Taranow

Darryl J. Blinski, MD · Answer

Great posted photos. I recommend open lateral capsule close techniques with hyperfix taping for 3 weeks postop and no use of upper arms for 3 weeks. . Fee $8,000. Best to virtual consult with...

Have my implants come out of their pocket? What are my options? 2 years post breast aug (photos)

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