Is it necessary to fix lateral displacement?

Question

I think they look fine when I'm standing up with my arms down. When I put my arms on my hips and lay down the LD is very visable. Is it necessary to fix? Is there a way to slow it down? Is it supposed to be painful? Sometimes when I run my right right side crease stings. Is this because of the LD? Thanks!

Jed H. Horowitz, MD, FACS · Answer

During breast implant surgery a #pocket is created carefully to maintain certain folds on the sides and bottom of the breast. Occasionally, the space for the breast implant becomes too large on the #side of the chest or the tissue stretches and the implants fall too much to the side. This is most easily seen when the patient is lying on her back. At times, the implants can move towards the patient’s armpit.
Treatment will generally require closing the space with a procedure called a #capsulorrhaphy. In this case, the capsule is closed off internally much as we do when we are trying to raise the breast fold. The capsule is closed with sutures and at times Acellular Dermis Matrix (#ADM) or other soft tissue substitutes would be used to further support this correction.Additional elective cosmetic #surgery is a personal choice. Your procedures should always be performed by a #Plastic Surgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for further revision surgeries.

Robert F. Centeno, MD, FACS · Answer

Thank you for your question.  While there is no immediate urgency to repairing a laterally displaced implant, it sounds like it may be causing you some problems. Sometimes lateral displacement can cause pressure or pulling on the nerves that give sensation to the nipple. This may explain some of your discomfort.  Repositioning the implant and tightening the capsule may help improve your symptoms.  Consider discussing further with your surgeon. Best wishes.

Bryson G. Richards, MD · Answer

Thank you for your question. It is natural for the breasts to fall slightly lateral when you lay supine. If you are unhappy, a lateral capsule tightening can be performed to hold the implants in a more medial (central) position. Be sure to consult with your surgeon or a board certified/eligible plastic surgeon.Best of luck!- Dr. Bryson Richards

Martin Jugenburg, MD · Answer

When you lay down your breasts will fall off to the side naturally to some degree. The degree at which it does and or how much it bothers you will be an indicator to have it fixed. See your chosen surgeon for an in person evaluation.

William Andrade, MD · Answer

Thanks for your question.  Lateral displacement of an implant does not necessarily have to be fixed. If it is either a significant cosmetic concern or causing symptoms, you could speak to your PS about options to change the implant position.

Steven L. Ringler, MD, FACS · Answer

Thank you for your question. Lateral displacement is very common with sub-muscular breast implants. Typically this will stabilize within 3-6 months of the surgery. If it is not getting worse, you do not have to "fix" it. If it bothers you or is getting progressively worse, then it would require a second surgery to correct this. For patients that are less than 3 months post op, I usually recommend they wear a bra 24/7 to keep the implant positioned properly. Also, avoiding heavy pectorals exercises can reduce the displacement. If it has been more than 6 months since your surgery, this will probably not get better. Good luck.

Steven Wallach, MD · Answer

In general, when patients lie down, their breasts will fall off to the side a bit.  I am not sure what you are looking for to control it?

Tom J. Pousti, MD · Answer

I am sorry to hear about the problem you are experiencing. Sometimes, a breast implant displacement/malposition problem, may be associated with significant discomfort. For example, if a woman's breast implant displaces inferiorly or laterally, there may be associated discomfort around those areas. One sign that the discomfort is related to the breast implant displacement is that the patient's discomfort improves when she supports the area where the breast implant tends to displace to. Often, the patient will demonstrate how her discomfort is improved when she supports the involved area with her hand or a  supportive bra.  In these cases, capsulorraphy can be very helpful. Although it is difficult to promise relief of pain with any surgical procedure,  I have seen significant improvement/relief of discomfort associated with capsulorraphy procedures. I hope this, and the attached link (dedicated to revisionary breast surgery concerns) helps.

Is it necessary to fix lateral displacement?

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