Implant slipped from under the muscle. How does this happen?

Question

i went for my a post op check up. im 4 months post op. i had concerns with the placement. left breast sits lower and implant is visible when flexing. right implant sits higher and not visible when flexing. left one seems to be dropping lower and lower as the months go by. My surgeon has advised a revision, to go in and replace the left one back under the muscle as he said it has slipped out. how does this happen?

Raymond Goh, MBBS (Hons), FRACS (Plast) · Answer

Hi. Thank you for posting your questions.
It is hard without examination or photos to decipher where the problem is. It is possible that implants can "slip out" under the pectoral muscle if the muscle has been elevated high. The dropping phenomenon may be reflective of this, or there could also be some degree of bottoming out. It's too hard to say without more clinical information. I would suggest a thorough discussion with your surgeon about what he thinks the issue is and what methods are indicated to improve things.
All the very best.
Dr Ray Goh

Leonard Tachmes, MD · Answer

Hi and welcome to our forum!
Bottoming out occurs if creation of the pocket disrupts the tissues which normally hold the implant in place. It can also occur with the use of large implants or if there is a connective tissue disorder weakening the structures. As the implant drifts downward, it slips out of the submuscular pocket which normally covers the superior aspect of the implant. 
Repair consists of repair of the ligamentous structures after the implant is manually displaced upward, resulting in reposition of the implant at a higher level.
Best wishes...

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery.
 Generally speaking, some factors that may increase risk of "bottoming out" include the need to "lower" the inframammary fold (disruption of the patient's natural supportive anatomy); this dissection (or over dissection) may predispose a patient to breast implant displacement complications.  Utilization of a breast implant that is too large for a patient's frame may also be problematic.
 "Genetic" factors (patient tissue concerns), in my opinion, play a very small role when it comes to potential problems with breast displacement.
It will be important that you feel comfortable that your plastic surgeon has significant experience helping patients with the type of revisionary surgery you may wish to undergo.
 
Best wishes for an outcome that you will be very pleased with long-term.

Mahmood Kara, MD - Account Suspended · Answer

Hello. Thank you for your inquiry and congratulations on your surgery!

It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.

It is crucial to get cleared by your doctor before engaging in specific physical activity before the 3 month healing period has ended as the healing stage is important for healthy results.

It generally takes around 6 months to a year to see your final results. Your tissues will take time to relax and allow your implants to "Drop and Fluff" settling into place. Should a revision cross your mind, it is best to wait at least 6 months to a year before doing so.

Our tips for recovery following breast augmentation are to wear a supportive sports bra for 3 months post-operative and refrain from lifting anything heavier than 10 lbs for 3 weeks as we don't want any strain at your incision sites. Make sure to keep the area of your stitches clean by cleansing with hydrogen peroxide daily. Showering is encouraged! But, no sitting in water for 2 weeks following surgery (no baths, hot tubs, pools etc.).

Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery. We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

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