Is it normal for breast implant to shift slightly when laying down?

Question

I have a 1 finger gap while standing but when laying down my gap is 2 finger wide. Are breast implants under the muscle supposed to move while laying down? I thought breast implants never move.. I am 3 weeks in and healing very well. They are not going under my armpits or anything.. just noticed the gap getting a bit wider. thanks!

Lily Daniali, MD · Answer

It sounds like you are noticing some lateralization of the implant when you lay down. Naturally the chest wall is sloped downwards as the chest wall ribcage curves backwards. When a person lays down our chest wall becomes like a slide and the implant at times will want to lateralize. First of all what you are describing is normal and seems very subtle. With more extreme changes, there may be more significant lateralization of the implant. This is why the implant fitting tightly into the breast pocket and careful dissection of the space is so critical. If the pocket is too big the implant can lateralize. Occasionally patients need the lateral pocket tightened up + consideration for a wider implant but that is only if the implant is narrow for the chest. If the implant fits your chest width and it continues to lateralize you may need the pocket tightened with a procedure called a capsulorraphy with possible internal mesh reinforcement such as Galaflex or durasorb. Again what you are describing is subtle and I would not worry at this point. Your post-op swelling is coming down so you may be noticing small motion in the pocket more. Small implant motion is very normal and actually a good thing to keep the pocket soft and non constricted. At this point in your recovery it is important to wear a supportive compression bra while you are healing and to follow your activity restrictions.

Leila Kasrai, MD, FRCSC · Answer

It is natural for the breasts to fall slightly to the sides when lying down. As long as they’re not under your armpits as you mentioned, it should be of no concern.

Jeffrey M. Darrow, MD · Answer

Breast implants placed below the pectoral muscle where the lower part of the muscle is divided to allow the implant to sit correctly, are affected by the action of that muscle over time. Each time the pectoral muscle contracts, it presses on the implant. The implant will not go superiorly (ie, against gravity),  nor medially (toward your cleavage), as there is still some of the pectoral muscle there. As there is no muscle, inferior or laterally, all implants have a tendency to move slightly inferiorly and slightly laterally over time, due to the pressure of the pectoral muscle.  When creating the pocket for the breast implant, the most minimal amount of dissection laterally helps to maintain the breast implants position as best as possible. Best wishes.

Daniel Barrett, MD · Answer

Dear jessica1234678910,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ted Eisenberg, DO, FACOS, FAACS · Answer

Implants settle and soften over 9 to 12 months. You will see about 80% of your final result by about 3 months. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

James Knoetgen, III, MD · Answer

It's normal for breast implants to shift slightly when you change positions, especially in the early weeks of healing. Since you are three weeks post-op, your body is still adjusting to the implants, and the tissue is softening around them. When you're standing, gravity keeps them in place, which may explain the smaller gap. When you're laying down, the position of the implants changes, and your muscles and tissues are not holding them in place as firmly, which could cause the gap to appear wider.
Implants under the muscle do have a bit more movement, and they can shift slightly due to the natural flexibility of the tissue and muscle. This movement usually becomes less noticeable as you heal and the surrounding tissue firms up around the implants. As long as they aren't shifting drastically or causing discomfort, this is generally considered a normal part of the healing process.
That being said, if you're concerned or notice any other changes that seem unusual, it's always a good idea to follow up with your surgeon to ensure everything is healing as expected.

Connie Hiers, MD, FACS · Answer

Yes, breasts, whether just natural (unless very small) or implants added, will fall to your sides when you lay down. Breasts with implants should move naturally and feel soft. If your implants are too large, they may not move much.

Camille Cash, MD · Answer

Congratulations on your surgery! What you described is completely normal.  The implants will shift and move with your body movements.  You will notice this a little more as you continue to heal from surgery and swelling resolves.

Richard R. Orr, MD · Answer

I would encourage you to check with your surgeon.  Implants this early can shift a bit.  Smooth implants can move quite a bit, and many times have to be held in position with elastic bands to help them stabilize.  Textured implants will shift a bit.  Early on, they can also have a small amount of fluid around them which can lead to some shift as well.
Check with your surgeon.  I usually encourage my patients to keep the implants pushed up and in to minimize muscle tension and gravity wanting to pull implants to the side and down.
Good luck to you!!

Is it normal for breast implant to shift slightly when laying down?

Answers (9)

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