3 months post op, is this a case of lateral displacement or is this just what implants are supposed to look like laying down?

Question

I am 3 months post op from breast lift and 365cc high profile silicone implants placed under the muscle. I am not sure if the distortion I see when I lay flat is normal or if the pockets are too large for my implants. There are no issues with appearance when I am standing or sitting or laying at a 44 degree angle. Only when I lay flat. Is this lateral displacement?

Gregory A. Buford, MD, FACS · Answer

I would agree with the other PS's in that a wider-based implant could potentially fill out the pocket better and create more medial fullness.  I would also tighten the lateral capsule.  I'm not sure that releasing the medial pocket is going to do much to fill out this area and could potentially create thinning of the tissues and ultimately rippling in this area.  Best to consult with the PS who actually performed your surgery or get a second in-person opinion.  I hope that helps and with you the best!Warmest regards,-Gregory A Buford MD FACS PCEOBoard Certified Plastic Surgeon and Author

Carlos Mata, MD, MBA, FACS · Answer

thanks for your question and excellent photos. I would absolutely say that you have lateral displacement of your implants. When you have high profile implants the implant is more narrow and now does not completely fill the base width of your breast and can cause lateral displacement. It can at times be normal but usually I dont see this happen so early on after a breastlift with implants. You may need capsule work, a wider implant or possibly mesh to prevent that from happening if it bothers you. But it can be considered a variation of normal. good luck! All the best,
Carlos Mata MD, MBA, FACS
Board certified Plastic Surgeon

Robert J. Spies, MD · Answer

i do think you have some lateral shifting of your breasts and implants.  it also seems like the high profile style may be a bit narrow for the width of your breasts which may add to the appearance of lateral shift.since it is only three months, let things heal more and then, if it bothers you, discuss with your surgeon.

Austin Hayes, MD · Answer

As others have said, it appears that the pocket where the implant was placed is allowing your implant to move laterally when you lie down. I would give yourself some additional time to assess your final results (2-3 months), but if this is bothersome you can consider a revision procedure. I use strattice mesh to build an internal bra and close off the outside of the pocket. Also, fully releasing the muscle to give beautiful cleavage is key.

Daniel Barrett, MD · Answer

Dear Zero_chan,I get this problem all of the time.  Typically, its from women who went with high profile implants.  This is a problem because while they project more, they are narrow at the base and can have widening effect on cleavage.  The second most common problem is incomplete release of the pectoralis muscle medially. Many surgeons don't take the time to make this right.  If you're not happy with your results I would suggest you to discuss it with your plastic surgeon. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Anthony A. Admire, MD, FACS · Answer

The implant pocket appears to have stretched during that time. However, that's quite unusual. I encounter this issue quite commonly, but mostly from women that have had implants for many, many years where the implant pockets stretch or lateralize over time. This is fixable. You need a major pocket revision. I don't use mesh and have a technique that keeps the implants more "on your chest" when you lay down by using your own tissues.

Robert M. Lowen, MD · Answer

Yes, the fact that you are ok standing but not lying, means that there is nothing holding the implants centrally when you lie down.  You might benefit from a revision with acellular dermal matrix like Strattice or a bioabsorbable mesh like Seri to close off the lateral pockets.

Curtis Wong, MD · Answer

is appreciated in your photos and you should be using a bra when sleeping to prevent lateral movement when on your back.  But improvement is not expected and if you wanted your mounds closer together, a revision of your pockets will be required (with medial release if indicated).  If you wanted wider mounds, go to Mod+ profiles instead of HP... and if you move your mounds medially, you may find your nipples lateralized as well so make sure you understand everything and what will happen before jumping in feet first.

William Albright, MD · Answer

Hello Zero_chan,
Yes you are correct.  The implants are being pulled by gravity and will slide along the contour of your rib cage (which is not flat).  This is analogous to women with large dense breast tissue.  Patients can default to wearing a bra, even at night, to try to prevent this shifting and further stretching of the soft tissues.  However, a mesh support can be considered to keep the implants on the front of the chest.  You should visit with your plastic surgeon for additional information.  Good Luck!
ABPS board certified plastic surgeon

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and you do appear to have lateral displacement.  So see your surgeon or other expert in the area and be evaluated in person

Dr Corbin

3 months post op, is this a case of lateral displacement or is this just what implants are supposed to look like laying down?

Answers (10)

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