Did the Surgeon Place my Implants Properly and Can They Be Fixed? (photo)

I'm 34 and 1.5YR PO. I was a small 32A cup and rcvd 375CC Silicone HP implants. Concern was within few weeks PO implants looked too low or nipples looked too high. Now they are worse. In addition to the nipples being too high, one is lower than the other are also too close together now. They also seem too firm. When pressing into the implant they are not squishy at all. The doc told me to wait at least 1yr post op to allow settling. They are worse. Not very happy and not sure what to do.

Doctor Answers 10

Did the Surgeon Place my Implants Properly and Can They Be Fixed?

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The implants do appear to be a little low on you but they also appear somewhat large for your frame (with the understanding that it's all relative).  That is probably the biggest factor contributing to making them firm; secondary is that they are high profile (probably necessary to get that size on your frame) which can, on occasion, feel more firm that a lower profile.  Implants can be raised but it's not that simple and greater asymmetry than what you have now may result.  In the end, though, you'll need to speak with your surgeon and go through the various options, including not having a revision.

I hope that this helps and good luck,

Dr. E

Best to direct concerns to your operating surgeon after surgery

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I would discuss your concerns with your operating surgeon - only he or she knows the operation performed as well as what was discussed pre-operatively.  You have waited over a year, so discussion of your concerns at this time is appropriate.

Breast Augmentation Disappointment

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Thank you for the photos.  I can appreciate your concerns.  In my opinion your implants are too big.  The implants do not seemed to be centered over the nipples.  Secondly, the firmness may be do to a thick internal scar (capsular contracture).  The resolution would be to downsize your implants, removal of the capsule and possible breast lift. Get several opinions by consultation from BC PS

Best Wishes

Dr. ES

Implant issues

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I think that the implants are too big for your body and they are too low. A smaller implant and fixing the fold would be helpful. Best to be evaluated in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Proper Implant Position?

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Sorry about your disappointment. Very likely your pre-op pictures would reveal a degree of asymmetry in breast crease and/or nipple position. Large implants may cause (as in your case) a "bottoming out" which can accentuate the asymmetry.

You didn't say whether or not you were pleased with the overall size of your breasts. A successful revision would likely require smaller implants as well as a correction of the bottoming out.

I suggest seeing several plastic surgeons to see which options would best meet your expectations.

Thanks for your question and best of luck!

Stephen M. Lazarus, MD
Knoxville Plastic Surgeon

Can They Be fixed?

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Absolutely this is fixable!  The implants are too large for your frame and too low on the chest.  Going smaller and changing to an implant with a lower profile will fix one of the issues. However, you need to have your inframammary fold significantly raised and reinforced.  This will position the implant higher and then the nipple will be in an appropriate position.  This can be a challenging procedure.  Make sure you choose a surgeon who specializes and has extensive experience in revisional breast surgery.  Ask to see pictures.  Good Luck!

Augmented breasts with too much implant volume below the horizontal pole will not improve with time

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The distance from the bottom of the areola to the infra mammary crease is well in excess of 6 cm in this photograph. This suggests that the pocket is stretched out due to the inability of the soft tissues to support the prosthesis. In my practice this is most commonly seen in sub muscular implants for the vector of force on the implant pushed it down and out when the muscle is engaged. Over time this causes the implant to bottom out.

Cosmetic Surgery is an Art and a Science

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Your problem may be related to the size of your implants and your small chest wall. Keep in mind you can have a revision at any time and consider a smaller implant. Discuss this with your PS.

1 Year After Breast Implants and Bottoming Out

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     If the breasts looked good early on but have gotten worse with time, you should consider a couple of things.  The pockets can be revised and the implants can be repositioned.  However, there may need to be some reinforcement of your natural tissues to prevent bottoming out from occurring again.  There are several materials that can be used.  Find a plastic surgeon with ELITE credentials who is an expert in breast augmentation revision.  Kenneth Hughes, MD Los Angeles, CA

Unhappy with implants

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I agree with you on both counts- the implants are too low, creating the appearance that the nipples are too high and pointing somewhat up, and also that there is asymmetry.  I can't tell about the softness.

This can be corrected surgically by modifying the pocket, and if needed capsulectomy.  The good news is that it is not as painful as the original procedure.


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.