"Side Boob" Really Bothers Me?

Question

Is this bc I chose an implant that is too big for my BWD? i am not sure what mine is bc my surgeon (not a plastic surgeon) dismissed me at 3 mos bc i was so upset about going too big. I chose 450cc round HP Mentor silicone implants which have a width of 13; however, my PS chose HP 350's which have a width of 11. The air gets cupped in my armpit a lot when I am not wearing a bra. I'm 5mos post op and aside from the large "side boob" issue, I still feel puffy in upper pole ...my start at 32A.

Stewart Wang, MD, FACS · Answer

There are several factors that can contribute to a "Side Boob" appearance. If you choose a breast implant that's too wide for your chest or if the surgeon created breast implant pocket that was too lateral. The angle or slope of your chest wall may also contribute to breast implant going off to the sides. Incomplete release of the muscle or excessive breast skin laxity can also contribute. It's best to carefully evaluate the cause before doing any revision. If you are not satisfied with your surgeon then consider getting a 2nd opinion with a board certified plastic surgeon.

	Best Wishes,

	Stewart Wang, MD FACS, Wang Plastic Surgery

Ali Sajjadian, MD, FACS · Answer

Hello,

	Thank you for sharing your photos and I am sorry for what you had to go through; the physician-patient communication is essential at all times.

	Unfortunately, without a physical consultation it is difficult to be able to provide you an accurate explanation to what you are exhibiting and hot to solve it definitively.

	Nonetheless, the "side boob" is mostly due to the placement of the implant in a pocket that does not fit it quite well. So a possible approach in this case will have to be a pocket correction surgery where the pec muscle is released to eliminate the high riding of the implant as well as the "side boob" effect.

	That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
	I hope this helps and please feel free to check the website below. 
	Thank you for your inquiry.
	The best of luck to you. 
	Dr. Sajjadian

Kenneth Hughes, MD · Answer

Although there is not a frontal view, I suspect that your result is very good and that the lateral fullness is not unattractive. However, if you want smaller implants, the pocket can be reduced at the lateral aspect.

George Bitar, MD · Answer

What patients commonly refer to as the "side boob" effect is the result of the selection of an implant that does not fit the chest wall and skin/breast tissue envelope.  This can happen for many reasons.  If the dimensional plannning the breast augmentation is not considered, then improperly sized implants can be selected.  In many situations this occurs because patients demand implants that are larger than their frames would benefit from.  A very good aesthetic outcome, such as that shown in the photo, can be achieved but it comes with some compromises.  The selection of larger implants can contribute to increased risk of wrinkling/palpability, malposition, and "side boobs."   You will need to discuss these issues further with your surgeon before deciding whether reoperation would be indicated.  Best wishes!

Tom J. Pousti, MD · Answer

Thanks for the question and pictures.

	Based on your level of concern, it may be  that your breast implants are too large for your frame. Revisionary breast surgery involving downsizing of breast implants and lateral breast implant suture technique (capsulorraphy) may be necessary to achieve your goals.

	 I would suggest in-person consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients in your situation.

	 Remember to communicate your goals carefully.

	 Best wishes.

Norman Bakshandeh Day, MD, FACS · Answer

A frontal picture would be revealing also. The fullness you feel and see in the upper pole is the high profile look. The lateral fullness is usually from an implant that is too large for your frame and chest wall.

Darryl J. Blinski, MD · Answer

Wow I am at a loss. The posted photos appear as a good result, even if done by a non boarded PS!. Also 13 vs 11 is 2 cm or less than 3/4inch. So maybe you need to allow another few months before considering additional surgery and the added costs and risks. Best to obtain IN PERSON consult with ONLY boarded PSs.

Vincent P. Marin, MD, FACS · Answer

It is difficult to appreciate from your photos, but by your explanation it appears that the implant is too wide for your frame. Downsizing the implant can help reduce the width and around of implant off to the side of your chest, but this would need to be determined in person. Also, you must consider the effect on the cleavage area as well as the projection on the upper part of the breast.

You should see a board certified plastic surgeon in your area to get a formal opinion through and in-person consultation.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

You should see a board certified plastic surgeon in your area to get a formal opinion through and in-person consultation.

Best of luck,

Vincent Marin, MD
	San Diego Plastic Surgeon

Larry Fan, MD · Answer

Dear Fun Size,

	There are many potential causes for "side boob" including overly wide implants, lateral implant malposition, concavity of the chest wall, and enlargement of a breast envelope that normally hangs to the side.

	Please see your original surgeon and/or an experienced, Board Certified Plastic Surgeon for an evaluation.

	Warmest wishes,

	Larry Fan, MD

Gregory Sexton, MD · Answer

It is hard to say what the problem is without seeing you. Smaller implants might help. Releasing the muscle more at the bottom might help-hard to say.

	You need to go back to your surgeon and talk to him, or consider a board certified Plastic Surgeon.

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