Breast falling to side when i lie down, is this normal? (photo)

Question

I am a month post op, i noticed after a strenuous work out (running and jumping i was wearing a sports bra) that my right boob seems to fall off towards my armpitt now when i lie down? Its like a 3-4 finger gap when i lie down. I dont know if this is normal or if i messed myself up, i saw my PS and he told me i am fine and normal boobs fall to the sides and that its related to my ribcage/anatomy as well.... Im just looking for a second opinion thank you.

Jose Perez-Gurri, MD, FACS · Answer

Hi. Whenever a patient stats that her breasts are "falling to the side" following abreast augmentation, the concern is whether the lateral extent of the pocket was made too large However, base on your pictures it is my opinion that this is not the case with you. Understand that breasts are meant to have some lateral displacement when the patient lies down. After an augmentation, the breasts should not be pointing straight up when the patient is lying down.You also need to consider that it's only been 1 month since your surgery......way too early to make a judgement as to the eventual position. I advice my patients that it can take anywhere from 3-6 months for subpectoral implants to settle. Relax, they look good and it seems you are progressing well. Good luck

Kamakshi Zeidler, MD · Answer

After breast augmentation with implants placed under the muscle, it is important to follow your plastic surgeons recommendations regarding work out restrictions. Some plastic surgeons will not want you do heavy lifting for 3 to 6 weeks after surgery to prevent the pectoralis major muscle from pushing your implants down and to the sides. Every patient's result from breast augmentation can vary based on pre-existing asymmetries in your anatomy from breast tissue down to the rib-cage. Implants fall to the sides especially when they are smooth and placed under the muscle due to that action of the pectoralis muscle. Some surgeons recommend that women keep their pec workouts to a minimum even after the early healing period. If the difference between your implants becomes significant, it may indicate that one breast pocket is too wide for the implant, and a revision may be needed to narrow the pocket. In these cases, the use of a tissue matrix often helps hold the implant in a better position.At this point it is very early in your recovery. I would listen to the advice of your plastic surgeon regarding activity level, and care of your breasts before becoming overly concerned.

Gilbert Lee, MD · Answer

It is a common finding that the breast implants move laterally when laying down.  If this is more notable on one side than the other it is usually due to the lateral pocket being more laterally dissected, either by the surgeon during surgery, or by the patient postoperatively.  The action of the pectoralis major muscle is to push the implants downward and laterally.  So, if you have been doing strenuous activities too early following surgery, the muscle action can push the implant laterally.  Luckily, your implants are in very good position with standing.  So, there does not appear to be a reason for correcting this issue at this time.  If however, the lateral displacement becomes worse or problematic, then a suture technique inside the pocket, or use of Acellular Dermal Matrix will help to centralize the implant.

Gustavo E. Galante, MD · Answer

It is normal for breasts to fall to the side when laying on your back. This would happen even without implants. From your photo, there does not seem to be much difference one side to the other. Be sure to follow up with your surgeon.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. You demonstrate your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, 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 it to layered suture technique 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.
I hope this (and the attached link) helps.

Ross Stutman, MD · Answer

Thank you for your question and photos. First, let me say that it is natural for breast tissue to fall to the side when you are laying down, and implants will do this as well. There is usually more movement if smooth (not textured) implants were used. It is unlikely that you displaced the implant with working out, however, I would defer to your plastic surgeon who has done a physical exam and seen you in person to know if anything was disrupted. Best Regards,Dr. Stutman

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and clearly from them one implant is falling too far laterally and would benefit from a revision though a full exam is really needed for me to be sure.Dr Corbin

Mary Lee Peters, MD (retired) · Answer

Thank you for your questions and photos. It is difficult to determine from that information, without an in person exam, if your implant positioning is on target. I typically do not advise strenuous work out until six weeks after surgery because tissues are not fully healed. If you are experiencing lateral displacement, there are ways to position an underwire bra to seal off the pocket laterally. Best to discuss this with your surgeon.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.   Your upright photo looks very good.  Implants can tend to fall to the side when lying down.  It is impossible to tell from the photograph but if your implant moves excessively to one side and causes discomfort you may need a revision of the pocket.  Please see your plastic surgeon.

Breast falling to side when i lie down, is this normal? (photo)

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