Do my breast fall too far to the side when laying flat? (photos)

I had a breast revision to correct capsular contracture and implant exchange 6 months ago. I'm satisfied with the overal surgery however I'm concerned my breast fall too far to the side when I lay flat.

Doctor Answers 9

Implants falling to the side

Although implants tend to fall laterally when lying flat, if they fall off too much you can have a pocket revision to re-position the implants.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck! 

Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Breasts migrate outward

It sounds like in an attempt to loosen the capsule it has allowed the breast implant to migrate off the chest wall. Unfortunately, given enough time and a large-size implant with gravity ,most implants will move slightly outward in the laying down position. If this gets to be a problem, than an operative correction would be to cinch up the outside capsule and maybe add something that doesn't stretch like and an ADM  such as Strattice or Galaflex.  best of luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Implant position

Thank you for your question. It is normal for the breast to fall to the side when lying flat. However, they can become too far apart. This can be corrected by internally  suturing the pocket around the implant.

Jon E. Rast, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 32 reviews

Breast Position After Revision

After a capsulectomy, the support of the breasts are removed and sometimes this can lead to a larger than ideal  breast pocket. This can result in poor position when supine. There are things you can do once the new capsule has healed and there is no evidence of recurrence of the contracture. Unfortunately, this will require another surgical procedure to internally tighten the breast capsule.

Be sure to find a board certified expert in revision breast surgery before you proceed. 

Best of luck,

Vincent Marin, MD

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Capsular Tissue

Thanks for the picture, I presume this is a picture of you laying flat, when removing the capsular tissue it removes essentially the lateral support to keep the implant in place and its fairly normal for the implants to fall sideways when lying on your back, the only way to fix this is to go back to surgery and repair the capsule

Robert M. Kachenmeister, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 26 reviews

Breasts too far apart

you are demonstrating breast lateralization, which is caused when your lateral breast tissues are either compromised during the capsulotomy/ectomy or if you are genetically prone to having weaker cutaneous to muscle/bone ligaments. Regardless, you can correct this with a breast augmentation revision where the lateral breast pockets are plicated/reinforced so that your implants remain on your chest rather than fall out into your armpits. Please see examples of breast augmentation revision below.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Do my breast fall too far to the side when laying flat?

From the appearance of your photos, I would say they are in the right position and that your natural breasts tend to go outward.  So the implant has to be placed properly under your nipple position.

Christopher Costanzo, MD
Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 39 reviews

Implant revision question

Good question!  This is one that many patients have after their surgery-- It is natural for the breasts to fall slightly to the sides when patients lie on their back.  So, the implant will tend to do this as well, sometimes to a greater extent if the soft-tissue pocket does not closely approximate the implant.  From your one photo, the result looks fairly symmetric, and more importantly, I don't see any evidence that the capsule has recurred.  In this photo you have a very natural look.  If you are happy with the result when you are upright and moving around throughout your day, then that is ideal.  As your surgeon likely informed you, revisional surgery for a capsule carries its own risk for recurrent capsular contracture: If you're happy with the result, and avoided a contracture this time, it's best to avoid any further surgeries if possible!  

Best wishes,

Erik Hoy, M.D.
Plastic Surgeon
Rhode Island 

Erik Hoy, MD
Warwick Plastic Surgeon
5.0 out of 5 stars 2 reviews

Do my breast fall too far to the side when laying flat?

Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients.  This phenomenon is called lateral displacement of the breast implant;  it may be of concern from the visual and the discomfort standpoints. I do NOT appreciate lateral breast implant displacement of your photograph.

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.    In my practice, I use a 2  layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option ( although not usually necessary)  especially if significant implant rippling/palpability is present.  Also, the use of a larger/wider breast implant may help improve/decrease the space between the breast implants.   

I hope this, and the attached link (dedicated to revisionary breast surgery concerns), helps.  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.