Is correction of lateral displacement worth the additional scars and complication risks? (Photo)

I have had my saline implants for 20 yrs that have laterally displaced. You can tell from my pic 20 years ago (2nd pic) that my breasts are naturally set apart. Would like to have them closer, smaller & use silicone to get rid of the mild rippling. But weary of scar, downtime & potential other complications (capsule issues, scarring,infection..)Do I lose what little hour glass exists if brought closer in? I am a competitive crossfitter &plan to continue with pull-ups, push ups, etc. Advice Pls!

Doctor Answers 7

The Concern of Lateral Displacement with Breast Implants

Additional elective cosmetic #surgery is a personal choice. A small inframammry or periareola scar should be adequate following the #healing period. But, the addition of #mesh may be helpful for additional internal #support. 

Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Horndeski Methodâ„¢

Immediately after surgery, your implants were too far apart and too low.Over time, they descended even more.Simply placing implants will not resolve your problem.You have excess skin.I recommend a new technique called Implant Exchange with The Horndeski Method™.The implants would be repositioned retro-pectorally, the breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.This technique avoids the ugly vertical scars of the traditional technique, maintains nipple sensation and the ability to breast feed.Attempting to use implants, strattice or other artificial materials will be unsuccessful.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Lateral implants

Over time, it appears your implants have descended and are lateral.
The rippling means your skin is thin as well.
My recommendation would be use smaller implants that are measured to fit your chest and utilize internal support with capsulorrhaphies and/or adm. Most likely this would require a lift which would entail external scars.

The best way to assess and give true advice would an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 93 reviews

Issues to consider with lateralized implants

Implants that are too far lateral can be repositioned with a procedure called capsulorrhaphy, which would not leave any external scars. However, there are important issues to consider in your case. Because you have more muscle development, if your implants are under the muscle then it is likely that muscle action is pushing the implants to the side. A simple capsule repair will not hold up in that situation. Repositioning the implants to the subfascial plane would help but you would lose coverage. Another consideration is that because you breasts are naturally far apart, moving the implants closer to the middle will leave the nipples off-center. Also, the nipples appear to be a little bit low. a lift would allow the nipples to be elevated and moved closer to the middle. 

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 54 reviews

Implant revision

Thanks for your question and pictures! You are thinking about all of the right things when considering another procedure. Here are a couple of thoughts:

1. New implant type: switching to silicone is a good idea. Given your low percentage body fat, you might want to consider a shaped (gummy bear) type of implant. There will be less wrinkling and no animation compared to traditional silicone (ideal for power-ups :)). Joking aside, my crossfit and athletic patients have loved these implants. 

2. Texturing on implants: you didn't mention this in your question, but it would be good to consider. Your pectoralis muscle puts a lot of down and out pressure on the implant. The texturing on the implant might help keep the implant high and inside were it should be. 

3. Lift: Your nipple position is lower than ideal. This will become worse when the implant position is corrected. This is a bummer, because we have new scars on the front of your breast. The upside is that you won't need nearly as much bra support post-op. The skin will be tailored to act as your new bra. 

4. Capsule, scarring and infection: These are always concerns after a breast surgery. Your implants have lasted a really long time, but I would imagine the are not going to make it another 10 years. Which is to say, you are going to have to do a revisionary surgery at some point. Why not control the where and when of the procedure?

Best of luck!

Bradley A. Hubbard, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 134 reviews

Lateralized Implants

While it can be tricky, correcting lateralized implants is VERY satisfying to people.  You can get a more narrow implant, but if you want to stay hour-glassy then don't go too much more narrow.  Unless you had implants via the armpit you typically could have that redone through the old incisions.  We see lots of very athletic women for are not alone.  

Good Luck!

Michael E. Decherd, MD
San Antonio Plastic Surgeon
4.9 out of 5 stars 54 reviews

Breast implant revision with a lift

Your questions are the right ones to consider.   I just removed implants from a triathlete recently.  Everyone is different.  Please have a consultation with a plastic surgeon in your area.  The Smart Beauty Guid is a good way to locate a Plastic Surgeon in your area.

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.