Lateral Movement Still an Issue. Is a BIGGER Implant the Answer?

Question

20+ years ago I had my first breast augmentation. Life and babies happened and I could feel major rippling in both implants (325 cc round saline) and when I would lay on my back I had major lateral movement. I decided it was time to replace the implants and in the process, address the lateral movement. I also wanted to go a little bigger this time. My PS and I discussed options to best handle the lateral movement and while he briefly mentioned the option of stitching the pocket and adding a mesh shelf he felt a larger implant would fix the problem. So my implants were reaplaced with 450 cc , moderate, silicone implants. From the moment the bandages came off I was disappointed. As hard as I looked I could not see a size difference at all. And when I lay down I still look flat chested with boobs in my armpits. I went back to my PS to discuss options. His opinion to help fill the stretched pocket and give me more upper pole fullness and less "flat chestedness" when I lay down would be to replace my new implants with larger ones. 700 cc to be exact. I asked why not stitch the pocket or use a mesh shelf and his feeling was that they don't last. I'm concerned that a larger implant didn't work the first time. I'm worried that 700 cc would be too big for me (I'm 5'8", 130 lbs, currently wear a 36C). Does this sound like a good fix?

Daniel Barrett, MD · Answer

Dear SimplyCreated,

breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.
Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.
While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.
If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Laura Roider, MD · Answer

@SimplyCreated thanks for your question. I understand that you have already increased the volume of your implant but it continues to lateralize when laying down. To address this I would recommend and adjustment to your implant pocket (capsulorrhaphy) and the use of an internal bra (absorbable supportive mesh) to help keep the implant from lateralizing. 
I will say that this problem can be difficult to address and may reoccur even when a capsulorrhaphy and internal bra.

Lateral Movement Still an Issue. Is a BIGGER Implant the Answer?

Answers (2)

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