Breast Implants That Do Not Settle

Your breast implants seem to be positioned too high. I don't believe that they are going to settle much without surgical intervention. Unfortunately, you will most likely need to have revision breast augmentation surgery.

The implants should be settles by 9 months.  This photograph shows preoperative bruising, so is much earlier after the surgery.  Your implants can definitely be lowered from this position without creating contour abnormalities.  Bands typically do not help, massage does.  If they are mobile and high, there is still hope that you can encourage them down.

You raise some very important points. First to replace your implants from the subglandular (beneath the breast) to the submuscular (beneath the muscle) pocket will take time to shape and drop, and you may require a breast lift. Your pictures reveal that the implants are high but you have wait the full time to heal to see where they finally end up. I don't believe you are looking at your final result. If the implants do not fall further and one year has passed then a breast lift (mastopexy) may be required. It is okay to stage this because you would have tried with less surgery.

From time to time, implants -  when placed under the muscle - do not fall adequately into the lower portion of the breasts. The photo you submitted suggests that the implant hasn’t fully dropped as expected. It is possible that a secondary procedure to release the breast tissue and/or the muscle in the lower portion of the breast will improve this condition. It is also possible that excessive scar tissue has enveloped the implant, causing it to sit too high. In this circumstance, removing scar tissue can also improve the appearance of the breast by lowering the implant. Finally, if there is loose breast tissue (sagging) over the implant, then a breast lift might be the desired approach. All of these possibilities can be evaluated by a plastic surgeon accustomed to doing corrective revisional breast implant surgery.

You will need another surgery to lower the implants to the appropriate position. An open inferior capsulotomy and possible capsulectomy will be necessary to reposition the implants correctly.

Hello! Thank you for your question! You are still early
post-procedure. Your appearance looks typical at this stage and will
continue to improve as the swelling subsides and the implants continue
to settle into their desired position. This usually proceeds over the
next several weeks as the lower pole skin/breast stretches to
accommodate the implants. Follow-up closely with your surgeon for
additional restrictions/instructions and the potential use of
bras/garments or massage that may encourage the implant to settle
appropriately. If still displaced after this time, a surgical procedure
may be necessary to further open the pocket and bring the implant(s)
down. Hope that this helps! Best wishes!

 it appears that your breast implants are seated to high and would require a revision surgery to release the inferior Lower The Position of the Implants. Sometimes with textured implants, the sense of the implant does not occur and the implants can stay in a unnaturally high position postoperatively despite massage and wearing a Bandeau.  I recommend that you follow your primary surgeon to discuss your concerns. The recovery from your revision surgery should be fairly easy as the majority of the dissection is already performed.

                  Your
pictures strongly suggest that you have superior malposition of your breast
implants after having them relocated to a sub muscular position. Since your
nine months post- surgery, it’s unlikely that the problem will get better
without surgical revision of the breast pocket. 

                  Superior
displacement of breast implants can occur for a variety of reasons. In the
early post-operative period this is often related to muscle spasm and swelling.
Unfortunately, when superior malposition of implants occurs late in the
post-operative course other possibilities need to be considered. The two most
likely causes are inadequate dissection of the lower breast pocket and the
development of capsular contracture. Unfortunately, both of these problems
require surgical intervention.

                  Correction
of this problem will require expansion of the inferior breast pocket
irregardless of the cause. It’s safe to say that massage and superior
compression bands will have no impact on this problem at this point.

                  It’s
important that you consult your original surgeon and express your concerns. In
some cases a second opinion may be helpful as well. 

It sounds as if the lower origin of the pectorals muscle needs to be released to allow the implants to settle into position.  Due to the dimensions of the implants, a larger volume of silicone is required to maintain your original size when switching from saline to silicone implants.  On average, this can be 50 -75 ccs or more.

You may have some element of capsular contracture which will limit settling of your breast implants. An exam will help cinch the diagnosis. I would likely suggest implant revision as one option of correcting the cosmetic appearance of your breasts. Raffy Karamanoukian Los Angeles

After 9 months, your implants should have dropped by now.  I don't think that additional massage, band wearing etc. is going to be of any benefit at this point.  It appears that you are going to need additional surgery to lower the pockets and therefore lower the implants.  As others have mentioned a capsular contracture on both sides could also cause this appearance, but that would be uncommon. 

If your original PS does not give you an answer that you are comfortable with, then you should consult with a few others (Board Certified PS).  Good Luck, Dr. Weider