Drifting Breast 9 Months Post Op?

After having a BA 9 months ago I noticed my breast isn't as full. Also, when I lay flat, my breast drifts under my arms and when I stand I have too much space where I should have cleavage. ( I went from a size B to a D)

Doctor Answers 4

Smaller, shifting breast implants. What this means.

As swelling decreases after surgery, your pectoralis muscles and breast skin also stretch, your breast tissues compresses, and your ribcage likely flattens slightly from the pressure/presence of your implants, regardless of type (saline or silicone). However, if you had saline implants placed, smaller size in one could indicate a leak or partial deflation. If both seem equally small(er), the more likely scenario is simply swelling resolution and change in your own tissues as I described above.

Your pockets are clearly larger than your implants, perhaps too much so, but large natural breasts flatten and drop towards the armpit area when a woman reclines, so the fact that your implants do so as well can either be natural, or excessive, particularly if your implants are moderate plus or high profile implants instead of wide(r) moderate profile. Switching to a lower profile or larger implant size can also improve your concerns.

Otherwise, if you have the size and profile implants you and your surgeon really want, then opening your pockets centrally (not too much or symmastia--uniboob--can occur) and closing the lateral pockets with sutures can help to more properly-place your implants. Remember, your implants should be centered beneath your nipple/areola complexes, not placed too closely towards the center to give cleavage while inadvertently creating "wall-eyed" nipple placement. If you already have proper position and lowest profile implants of the size you want, cleavage can be obtained not by additional surgery, but by a push-up bra. At a D-cup in size, you would likely be helped by lower profile implants, along with capsulotomy (medially) and capsulorrhaphy (laterally).

Please talk to your plastic surgeon, or have additional consultations with ABPS-certified plastic surgeons in your area. Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

BA results

Were the breasts full immediately after surgery? Are the implants fairly large? It's possible the space the implants were placed within has expanded. To improve this would require stitching the side of the pocket to decrease its size and push the implants more centrally to create cleavage. I would recommend you followup with your plastic surgeon to see what he/she thinks. Take care!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 51 reviews

Not uncommon problem

Dear Tigerlady,

unfortunately your problem is not uncommon. Most likely you have inflatable smooth implants placed under the pectoral muscle. As Dr Pousti suggests the only solution while keeping the same implants is indeed a capsulorraphy. 

In Europe the best alternative would be to place silicone gel implants with a coating of polyurethane, which creates a very good adhesion to the desired position immediately after placement. Moreover this polyurethane has proven to give a significant protection against capsular contracture. 

Alexis Verpaele, MD
Belgium Plastic Surgeon

Drifting Breast Implants?

Thank you for the question.

 Based on your description, your breast implants are moving to the sides (are laterally displacing). This situation can be corrected using an internal suture technique (capsulorraphy) decreasing the size of the breast implant pockets and moving the implants toward the midline.  This procedure will serve to help improve the appearance of the cleavage area both in the upright and supine positions.

 I would suggest an in-person consultation with board certified plastic surgeons who can demonstrate significant experience helping patients with lateral breast implant displacement. You may find the attached link helpful.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

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.