16 months post op - super far apart and low on my chest. Can my results be improved? (Photos)

Question

Hi I had my implants done almost 16 months ago. From the very beginning I didn’t like how they looked and I was told this is because of my chest anatomy. I had 450cc under muscle. They are super far apart and also really low down on my chest and I have no upper fullness. They are still firm not like real breasts and they move sideways within the pocket. Can this be improved?

Mert Demirel, MD · Answer

At 16 months, your result is mature, so if the implants are still far apart, low, firm, and moving sideways in the pocket, it is reasonable to seek a revision opinion.
Some spacing is related to natural chest anatomy, especially if the breast footprints sit wide apart. Surgery cannot safely move implants past the natural inner breast border without risking symmastia. However, if the pockets are too wide, too low, or poorly controlled, the position can often be improved.
The sideways movement suggests possible lateral pocket over-dissection or pocket stretching. The low position and lack of upper fullness may suggest bottoming out, implant settling, or an implant/pocket mismatch. Firmness also raises the question of capsule tightness or capsular contracture, although an exam is needed to diagnose that.
Revision options may include capsulorrhaphy to tighten the outer pocket, raising or reinforcing the inframammary fold, changing implant size or profile, using internal support such as mesh in selected cases, or adjusting the pocket plane. If the skin or nipple position is low, a lift may also be needed.
My advice would be to see a revision breast surgeon and ask for a clear diagnosis: wide natural breast spacing, lateral displacement, bottoming out, capsular contracture, or a combination. Improvement is often possible, but the plan must control the pocket and respect your natural chest anatomy rather than simply placing another implant.

John L. Burns Jr., MD · Answer

Yes, you can adjust the capsule/pocket using internal sutures and I'd recommend also supporting this with an internal mesh bra like DuraSorb.

Chul Hwan Seul, MD, PhD · Answer

Hello.

It is true that some of the issues you are experiencing are related to your natural chest anatomy. However, there are several surgical adjustments that could significantly improve both the appearance and feel of your breasts.

I would recommend:

- Raising the position of the implants slightly.
- Replacing the current implants with ones that have a similar or slightly larger diameter, but a lower projection.
- Reducing the excess implant pocket on the outer sides of the breasts to improve implant positioning.
- Performing fat grafting to areas with insufficient soft tissue coverage, including the implant edges, the cleavage area, and the upper chest.

These changes can create breasts that look more natural, feel softer, and have a more harmonious overall shape compared to your current result.

Jed H. Horowitz, MD, FACS · Answer

Breast implant surgery can always be improved
Implant Position
Over time, aging, gravity, weight change, and other factors can cause breast implants to shift within the body, leading to an unnatural appearance. This often occurs with certain types of shaped implants. Surgery can reposition or remove the implants to improve the appearance of your chest.
Some implants, especially those that are smooth and shaped, may move within the breast pocket, causing a deformed appearance. Sometimes, the implants can shift too close together, causing a ‘uni-boob’ appearance. The displaced implants are repositioned with breast augmentation revision to restore their correct positioning.   This may require different implants and the use of mesh to stablize the position

16 months post op - super far apart and low on my chest. Can my results be improved? (Photos)

Answers (4)

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