Is the best way to correct lateral displacement to perform a capsulorraphy or to use a bigger implant to fill in the centre gap?

Thank you for your questions. This is a very good topic to discuss with your surgeon. If the implant pocket has widened over time, many patients assume that the easy answer is to just place a wider implant. The problem with this is that if the pocket has not widened medially as well as laterally, placing a new wider implant will result in a laterally displaced implant that is not centered beneath the nipple. It is an easy fix to the problem but can produce a poor result if not planned carefully. If the pocket has been displaced only laterally, then a capsule repair +/- mesh support is the right answer. Often times, this can be combined with a slight increase in the width of the implant (if you are interested in being larger) with very nice results. Make sure you see a local board certified plastic surgeon for a consultation.Hope this helps!

as larger implants will mostly contribute more to side boob rather than anything else.  If you're happy with size, keep your current implants and avoid the added costs of new implants (unless your surgeon will provide them to you free).  I try to avoid using any artificial materials so my preference to diminish the lateral pocket is to remove the excess capsule, and sew the skin down to the chest wall followed by the capsule to each other inside the pocket and making sure the medial release is adequate.  Recovery requires use of a cut out underwire bra 24/7 (yes, even in the shower) for 6-8 weeks and the outcome is still not predictable as sutures can fail.  And your activities are restricted for the whole time!

I am sorry to hear about the problem you are experiencing.   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. Surgical correction is an option.
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 (capsulorraphy) 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.I find that for the majority of patients who present with lateral breast implant displacement concerns, the use of larger breast implants is helpful. Best wishes.
  

Since your current implant base with diameter sounds appropriate for your chest dimensions I would not recommend a larger implant but instead would do lateral capsulorrhaphy.  I feeling is that a larger wider and heavier implant will simply stress repair and increase the likelihood of recurrence.Discuss your specific situation with your plastic surgeon before making a final decision.  Capsulorrhaphy is usually quite successful in my experience.  Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California