My Right Breast Looks Deformed After Augmentation

I had a below the muscle, anatomical implant augmentation 3 years ago and my right breast has always caused me problems. Sometimes it ripples, other times it looks like the implant has rotated but then it corrects itself. I saw my plastic surgeon a few months ago but on the day of consultation my right breast appeared normal so he said all seems ok. However, for the last 5 days my right breast has appeared deformed and is not correcting itself(picture attached). Advice appreciated, I'm worried.

Doctor Answers 10

I'm not a big fan of anatomic implants

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Thanks for the great photos.  You need to take those to your plastic surgeon...Then he will see the light (and the rotation);-)   You implant is clearly rotating within the pocket. This is luckily not too common a problem, but clearly your implant is in too big a pocket. This must happen fairly easily; my guess is you can reposition the implant if you try.  This is probably your cheapest way out, but may not be a great option if you are on the beach in a bikini.  Changing out to round silicone implants is probably your best option.   Good Luck!

Deformed breast after augmentation (with textured "anatomic" implants)--what to do now?

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With any type of shaped implant ("anatomic" is a misnomer, since the natural breast is teardrop-shaped only when you are upright; when you recline, the breast becomes round, flattens, and drops slightly to the side--it does not remain teardrop-shaped!) the shape needs to be oriented correctly. This is why the implants are textured--they need to adhere to the tissue so they can't rotate into abnormal shapes like your photos clearly show. Your surgeon saw them when your implant had rotated back into it's proper position, and now it is out again--clear and unequivocal evidence that your implant is NOT properly adhered to its capsule. Re-operation will not correct this problem unless the entire capsule is removed and your surgeon has better luck this time in getting adherence to occur!

I would suggest switching to smooth round implants, which are teardrop-shaped in the upright position, and flatten and round out when you are supine, just like normally-larger breasts do! This is why I am not a "fan" of teardrop or so-called "anatomic" implants--they do not move normally, they are rotationally sensitive to initial placement (or they are permanently "off" if they rotate and then heal in a skewed position), and they remain teardrop-shaped when you recline, which is neither "anatomic" nor normal-looking!

Since you need a re-operation if you want this issue corrected, make sure you  choose correctly, even if it means purchasing new silicone gel round smooth imlants. Show your surgeon your photos--clear evidence of loss of adhesion. Best wishes!

Breast augmentation

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As mentioned above the implant may have rotated and you may also have  capsular contracture which is causing the irregular shape

Movement of Anatomic Implants

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When implants change in their appearance, we have to consider what is causing the change. It could be the implant, the capsule, the breast pocket, or the skin. One of the downsides of anatomic implants is that they require a very precise pocket, so that their position can't change.

From your photos, it appears that your implant has rotated 180 degrees- it is upside down. It doesn't appear to be damaged as the size and shape appear equal to the other breast., The fact that is relocates suggests that your pocket is too loose. Therefore, your pocket must be tightened. Again, this requires great precision, Another options is to convert to round smooth gel implants. These give a natural appearance with gravity, and rotation is not a concern.

Problem with TEAR DROP implants

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Thanks for the great photos. Your tear drop implant has rotated on the right due to a tooo large pocket. Best to change to a HP round implant or learn to re rotate the implant back into position. From MIAMI 

PS I RARELY ever yse these type of implants. 

Rotation of the implant is a downside of anatomical breast implants

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"Anatomical" or tear drop shaped breast implants were thought to be a great advance.  But like many great ideas, they didn't turn out to be so good for the augmentation patient because they don't always heal in position and stay there.  Round implants work better and don't look "round" as along as they are not too high profile and full.

Anatomical Breast Implant

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It is not uncommon for a tear-drop shaped or anatomical shaped implant to rotate. That is the downfall with these types of implants, which I why I recommend smooth round style implants. Have you considered switching to a smooth round style silicone implant? Those implants have a softer more natural appearance and you will not have to worry if the implant shifts or rotates.  

See your surgeon for revision surgery

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I am sorry to hear that you’ve had a bad experience. You should definitely see your surgeon to talk about your concerns. Judging from your photos, you’ll probably need revision surgery which may involve replacing your implants with round shaped implants to eliminate the risk of rotation.

Breast deformity

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Breast deformity can result from capsular contracture or implant malposition.  When an anatomic implant is used, there is concern for implant rotation or malposition, especially if the deformity comes and goes.

Dennis Dass, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 174 reviews

Breast Implants - Appearance of Right Breast, Anatomical Implant

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Hi Downunder01 in Melbourne, 07,

The problem may be exactly what you suspect:  that your implant rotates.

Although anatomical implants are used widely, they are not usually my preferred implants.   There are several reasons for this but among them is that if they rotate off the desired axis by even 5-10 degrees it can be quite noticeable.  That appears to be what has happened with you.

You may also have some scar tissue around the implant which, if severe, would be termed a capsular contracture.

Either way, you would probably benefit from removing your existing implants and switching them for smooth, round, moderate plus silicone gel implants, with the removal of some or all of the scar tissue.  I think that that combination of procedures would be most likely to produce the result you'd like.

You should, of course, discuss this with your own plastic surgeon - and preferably on a day in which the deformity is seen.  However, taking enough photographs should be good enough to demonstrate the problem.

I hope that this helps, and good luck,

Dr. E

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.