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Breast implants fall into armpits when laying down. Can anything be done? (Photo)

I got my saline implant surgery 6 years ago and was told that because of my chest I would not have cleavage. This was understood, but, I did not think that that meant that they would fall into my armpits when I lay down which is very uncomfortable. I had absolutely no boobs to start with just a nipple. I am very self conscious about them and cannot wear bathing suits I want to because of this. Please let me know if you think I have any options.

Doctor Answers 14

My Breast Implants Fall Into My Armpit When I Lay Down - Can This Be Corrected?

January 25th, 2015
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The short answer to your question is "yes".

Implants which fall into the armpit are displaced laterally within the breast implant pocket.  The pocket can be closed laterally using several techniques, and then opened more medially to give some degree of improved cleavage.  If your implants are on top of the muscle, going into the subpectoral space can often limit the lateral movement of the implants. 

That being said, if you were my patient, I prefer both above and below the muscle to do a capsulorraphy which closes down the lateral portion of the breast implant pocket, and then reinforcing that pocket with Seri scaffolding.  This surgery can be performed through an incision around the edge of the areola leaving minimal to no scarring and creating a more natural breast position and shape. 

I recommend you seek out a Board Certified plastic surgeon in your neighborhood who has experience in breast revisions, especially with the use of Seri.
S. Larry Schlesinger, MD, FACS
January 25th, 2015

My Breast Implants Fall Into My Armpit When I Lay Down - Can This Be Corrected?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The short answer to your question is "yes".

Implants which fall into the armpit are displaced laterally within the breast implant pocket.  The pocket can be closed laterally using several techniques, and then opened more medially to give some degree of improved cleavage.  If your implants are on top of the muscle, going into the subpectoral space can often limit the lateral movement of the implants. 

That being said, if you were my patient, I prefer both above and below the muscle to do a capsulorraphy which closes down the lateral portion of the breast implant pocket, and then reinforcing that pocket with Seri scaffolding.  This surgery can be performed through an incision around the edge of the areola leaving minimal to no scarring and creating a more natural breast position and shape. 

I recommend you seek out a Board Certified plastic surgeon in your neighborhood who has experience in breast revisions, especially with the use of Seri.
S. Larry Schlesinger, MD, FACS

Breast implants fall into armpits when laying down. Can anything be done?

January 25th, 2015
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I am sorry to hear about the problem you are experiencing after breast augmentation surgery. Based on your description and pictures, it seems like you are experiencing a breast implant displacement problem.

Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline.    Doing so will prevent the breast implants from migrating to the sides when you lie down and will help centralize the position on the breast mounds. In my practice, this repair is done with a 2 layered suture technique. The use of acellular dermal matrix is an option ( although not usually necessary)  especially if significant implant rippling/palpability is present.

 I hope this (and the attached link) helps.

Web reference: http://www.poustiplasticsurgery.com/Procedures/procedure_revisionarybreastsurgery.htm

Tom J. Pousti, MD, FACS
January 25th, 2015

Breast implants fall into armpits when laying down. Can anything be done?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I am sorry to hear about the problem you are experiencing after breast augmentation surgery. Based on your description and pictures, it seems like you are experiencing a breast implant displacement problem.

Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline.    Doing so will prevent the breast implants from migrating to the sides when you lie down and will help centralize the position on the breast mounds. In my practice, this repair is done with a 2 layered suture technique. The use of acellular dermal matrix is an option ( although not usually necessary)  especially if significant implant rippling/palpability is present.

 I hope this (and the attached link) helps.

Learn more: http://www.poustiplasticsurgery.com/Procedures/procedure_revisionarybreastsurgery.htm

Tom J. Pousti, MD, FACS

Breast implants fall into armpits when laying down. Can anything be done? (Photo)

February 17th, 2015
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Yes.  This can be corrected with a procedure called a capsulorraphy.  Internal sutures will close the pocket laterally (along the side) so they won't fall to the side when you lay down. Talk with your surgeon so you can better understand the risks and benefits involved with the procedure and go from there.  ac
Angela Champion, MD

Angela Champion, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 5 reviews

February 17th, 2015

Breast implants fall into armpits when laying down. Can anything be done? (Photo)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Yes.  This can be corrected with a procedure called a capsulorraphy.  Internal sutures will close the pocket laterally (along the side) so they won't fall to the side when you lay down. Talk with your surgeon so you can better understand the risks and benefits involved with the procedure and go from there.  ac

Angela Champion, MD
Newport Beach Plastic Surgeon

Breast implants fall into armpits when laying down. Can anything be done?

January 27th, 2015
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Yes this can be fixed. The procedure involves removing the implants and suturing the outside or lateral portion of the implant pocket closed. This will move implants toward the center, improve cleavage and stop them from falling to the side.

Web reference: http://www.bostonplasticsurgeryspecialists.com/services/breast-surgery/breast-augmentation/

Brooke R. Seckel, MD, FACS
January 27th, 2015

Breast implants fall into armpits when laying down. Can anything be done?

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Yes this can be fixed. The procedure involves removing the implants and suturing the outside or lateral portion of the implant pocket closed. This will move implants toward the center, improve cleavage and stop them from falling to the side.

Learn more: http://www.bostonplasticsurgeryspecialists.com/services/breast-surgery/breast-augmentation/

Brooke R. Seckel, MD, FACS

Pocket issue

January 26th, 2015
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This is most likely due to a very large capsule that may need revision to tighten up the pocket along the lateral region.  Best to be seen in person.

Web reference: http://www.stevenwallachmd.com/breast-procedures/breast-augmentation-new-york/

Steven Wallach, MD
January 26th, 2015

Pocket issue

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This is most likely due to a very large capsule that may need revision to tighten up the pocket along the lateral region.  Best to be seen in person.

Learn more: http://www.stevenwallachmd.com/breast-procedures/breast-augmentation-new-york/

Steven Wallach, MD

My comments

January 26th, 2015
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Saline implants are widely outscored by modern cohesive gel-filled textured implants with anatomical shape, so my advice is moving to these, specially becaus they are not smooth.

Smooth implants like yours have NO adherence to ribcage, so their weight lies directly on the cutaneous brassier, it is your own breast and gland that has to hold the implant in place. Needless to say this is limited in time, so sooner or later the implants dislocate downwards or laterally, suffering the so called excessive mobility. They may mainly go downwards, producing bottom out, or laterally like yours, creating an additional pocket under your armpit.

The treatment must follow these guidelines:
-wider implants, you CAN have cleavage
-anatomical profile implants
-cohesive gel-filled
-macrotextured to produce adherence to ribcage, but my advice is polyrethane coated implants, these latter are the top in the market about fixation and the ideal in cases like yours
-multi-point capsulorraphy to close the laterally excessive pocket

Not any surgeon can provide you this therapy, do a good research and travel wherever is necessary to obtain the best treatment for you.
Alejandro Nogueira, MD

Alejandro Nogueira, MD
Spain Plastic Surgeon
4.8 out of 5 stars 49 reviews

January 26th, 2015

My comments

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Saline implants are widely outscored by modern cohesive gel-filled textured implants with anatomical shape, so my advice is moving to these, specially becaus they are not smooth.

Smooth implants like yours have NO adherence to ribcage, so their weight lies directly on the cutaneous brassier, it is your own breast and gland that has to hold the implant in place. Needless to say this is limited in time, so sooner or later the implants dislocate downwards or laterally, suffering the so called excessive mobility. They may mainly go downwards, producing bottom out, or laterally like yours, creating an additional pocket under your armpit.

The treatment must follow these guidelines:
-wider implants, you CAN have cleavage
-anatomical profile implants
-cohesive gel-filled
-macrotextured to produce adherence to ribcage, but my advice is polyrethane coated implants, these latter are the top in the market about fixation and the ideal in cases like yours
-multi-point capsulorraphy to close the laterally excessive pocket

Not any surgeon can provide you this therapy, do a good research and travel wherever is necessary to obtain the best treatment for you.

Alejandro Nogueira, MD
Spain Plastic Surgeon

Excessive Implant movement when lying down

January 26th, 2015
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I believe your situation can be corrected. A "net" of ligaments is found around the breast gland and this is not only the support of the breast gland but also the implant placed behind the breast (or breast and muscle). When this "net" is stretched out or disrupted the implant loses support, and when lying down the implant can move outside the "net" and fall into the armpit. The "net" ligaments can be sutured back to the chest wall in a surgical procedure known as a Capsulorraphy. This can generally be performed under sedation and local anesthesia, but it is critical to get the "net" back to the chest wall in a symmetrical fashion. Please seek a consult from a Board-certified Plastic Surgeon about your issue.
Douglas Leppink, MD

Douglas Leppink, MD
Grand Rapids Plastic Surgeon
4.8 out of 5 stars 27 reviews

January 26th, 2015

Excessive Implant movement when lying down

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I believe your situation can be corrected. A "net" of ligaments is found around the breast gland and this is not only the support of the breast gland but also the implant placed behind the breast (or breast and muscle). When this "net" is stretched out or disrupted the implant loses support, and when lying down the implant can move outside the "net" and fall into the armpit. The "net" ligaments can be sutured back to the chest wall in a surgical procedure known as a Capsulorraphy. This can generally be performed under sedation and local anesthesia, but it is critical to get the "net" back to the chest wall in a symmetrical fashion. Please seek a consult from a Board-certified Plastic Surgeon about your issue.
Douglas Leppink, MD

Douglas Leppink, MD
Grand Rapids Plastic Surgeon
4.8 out of 5 stars 27 reviews

Breast implants fall into armpits when laying down. Can anything be done?

January 26th, 2015
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Yes additional open surgery to close the lateral pocket of the implant cavity. Best to discuss with your original surgeon or seek a new one. 
Darryl J. Blinski, MD
January 26th, 2015

Breast implants fall into armpits when laying down. Can anything be done?

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Yes additional open surgery to close the lateral pocket of the implant cavity. Best to discuss with your original surgeon or seek a new one. 
Darryl J. Blinski, MD

Breast implant pocket

January 26th, 2015
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Thanks for your question and pictures and sorry about your dissatisfaction.  You do have options for breast revision surgery which can help the problem you describe.  Either moving your breast pocket medially (towards the middle) some and changing the shape of your implant can achieve some increased cleavage. Also it will minimize how much they move to the side when you lay down.  Good luck.
Khashayar Mohebali, MD, FACS
January 26th, 2015

Breast implant pocket

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for your question and pictures and sorry about your dissatisfaction.  You do have options for breast revision surgery which can help the problem you describe.  Either moving your breast pocket medially (towards the middle) some and changing the shape of your implant can achieve some increased cleavage. Also it will minimize how much they move to the side when you lay down.  Good luck.
Khashayar Mohebali, MD, FACS

Lateral breast implant displacement

January 26th, 2015
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You can repair the pocket with sutures and push the implants back up toward the middle. Maybe go a little wider with the implants to get better cleavage. You need an expert revision breast surgeon.
Richard P. Rand, MD, FACS
January 26th, 2015

Lateral breast implant displacement

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
You can repair the pocket with sutures and push the implants back up toward the middle. Maybe go a little wider with the implants to get better cleavage. You need an expert revision breast surgeon.
Richard P. Rand, MD, FACS

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.