Do My Breasts Post-BA Look Uneven, Deformed and Too High?

I had moderate profile Mentor 325s placed under the muscle through the armpit almost 5 months ago. I am very petite (Size 0) and have firm tight skin. My range of motion is still only 90%. Pre-surgery, I was a 32A with slightly droopy nipples (shrunk from a 32C after children. During pregnancy I grew to a 32F and my breasts looked nice, even and not droopy.) My doctor is saying I look normal, which is obviously not the case. How do you think I look? Do you think I will drop and fluff more?

Doctor Answers 31

OOPS!! Implants too high

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Without seeing your pre-operative photos, I can only speculate on your appearance before the surgery, but it appears that you have  a "high crease".  The distance between the nipple and your inframammary crease was (and still is too short).  It is an optical illusion that makes even small breasts look droopy or ptotic.  The breast implants need to be placed in a lower position on the chest wall and create a "new" inframammary crease. 

Also, I believe you had a wide cleavage gap, your breasts and subsequently your nipples are pointing out to the side.  The placement of the implants is too far medial (toward the middle) and too high.  You will need to have the implants repositioned laterally and inferiorly.  This is a difficult, but not impossible, secondary maneuver through the axilla (armpit).  I would recommend using either a peri-areolar (under the areola) or inframammary incision (under the breast) to re-position your implants.  The placement of the implants is easier to control through direct access incisions rather than trans-axillary or trans-umbilical (belly button).  Unfortunately, the axillary incision commonly leaves the implants in this position, especially someone with your body build.

Omaha Plastic Surgeon
4.9 out of 5 stars 83 reviews

Implant Malposition

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Hello Pettitegirl5,

Your re-posting yielded more responses this time.  Please review mine again:

Both of your implants are sitting too high, especially the right implant, to be considered normal. It is very difficult to make truly accurate assessments with only photographs and not conduct an actual examination, but it looks like there may be an element of capsular contracture to the right implant, and neither look like they are sitting against your natural inframammary fold, something we would expect after an augmentation.

Regardless of why your implants are too high, I will give you assurance that vigorous massage, vitamin E, compressive bands, or pharmaceuticals like Singulair or Accolate will not be effective. It is possible that given enough time they may drop some, but not to the extent that I think you would find pleasing.

Most likely you will need to have a revision surgery that will improve the position of your implants and address any other concomitant issues you may or may not be having (capsular contracture). Revision surgery is more complicated and requires extensive experience on the part of the surgeon. I would recommend that you consult highly regarded breast surgery specialists and get second opinions. These doctors are certified by the American Board of Plastic Surgery and are usually also members of the American Society for Aesthetic Plastic Surgery.

Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Breast augmentation -getting it right the first time

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Your photos show high implants, square shaped breasts and symmastia. I suspect the implant base diameter is too large for your "very petite" frame and the pocket and the muscle was not adequately freed up on the inner lower quadrants of the breast. The smooth round moderate profile style 1600 325cc has a base diameter of 12.6 to 13cm. I suspect your frame will not aesthetically hold a base diameter of more than 11cm.

You can wait a year or 10 years but I do not think this will change much. You will need additional surgery with placement of different implants, release of the muscle in the lower inner quadrants and adjustment of the implant pockets in order to fix this. You need to get copies of your operative report and before/after photos if you decide to go with another surgeon. 5 or 6 months is sufficient time for a revision surgery.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Breast implants too high after surgery

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Based on your photos it appears your breast implants are too high and should have "dropped" by five months. You could have capsular contracture which is preventing your implants from settling. I would discuss this with your plastic surgeon to see if you need a revision to lower the implants or to downsize the implants. If you have capsular contracture (hard scar tissue) you may need this scar tissue removed as well.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 412 reviews

Implant position too high can be the result of an under-released muscle

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There is a good chance that the lower border of your pectoralis muscle was not sufficiently released thereby maintaining the implants too high on your chest.  An unreleased or underreleased pectoralis muscle is more likely to be seen with implants placed through the armpit particularly when this is done blindly (a scope is not used).  Fortunately, correction of this issue is relatively straightforward.  It can be done through the arm pit again but I suggest having an incision at the border of he areola or at the breast fold to make sure that you get the proper pocket the second time around.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

A combination of implants that appear to high post-operatively, and a shortened distance

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between the nipples and the inframammary fold can occur when implants are placed through the transaxillary approach.  I would not be surprised to hear that you can see the implants migrate upward when you tighten your pectoralis muscles.  Occasionally the implants can migrate downwards with massage and time, but more commonly your surgeon will have to go back and release the lower pole muscles to allow the implants t e re-positioned further down on the breasts.  This is much more easily done through an incision along the bottom of the breasts, and should greatly improve the appearance of your breasts. 

Michael H. Rosenberg, MD
Mount Kisco Plastic Surgeon

Implants too high and result is less than ideal - revision indicated

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Your implants are clearly situated too high and their position will not improve with additional time. A revision is clearly indicated for you tin order to obtain a more desirable result. It is my opinion that the implants that you have right now may not be the right size or configuration based on your breast shape and body configuration. A revision using these same implants may give you a result that still falls short of being satisfactory.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.7 out of 5 stars 33 reviews

Are my breasts uneven after breast augmentation?

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It looks as though you have high riding implants or "malposition". At five months after breast augmentation, the position of the implants could improve, but not dramatically. This is a common ocurrence when having a breast augmentation done through the axilla, although it is avoidable. You may require a revision either through the axilla, but more than likely, through an incision in the inferior breast fold.

Breast implants are too high

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Your breast implants are too high and at this point I would not expect them to change much.  There are often subtle changes in the position of breast implants over time but by 3 months I would expect them to have settled more.  I would discuss with your surgeon about breast implant revision surgery.  In this case I would make an incision in the lower breast crease and further release the lower pole tissue in order to allow the implant to fully drop.  The goal is always to get the implant to settle behind the nipple so that the nipple is on the most projecting part of the breast.  That can be accomplished for you but will unfortunately require an additional procedure.  Good luck.

Jason E. Leedy, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 148 reviews

Breast implant position

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yes the implants are too high.  i generally give 6 months before talking about revision. i think a revision may be necessary and a muscle release may be apprpriate as well in order to get your implants to the right level. good luck

Jonathan Saunders, MD
Newark Plastic Surgeon

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.