Strange implant shape almost 1 year out from surgery - will this become less visible or will I need a revision? (Photos)

Question

Hopefully I will be able to get some clarity on what might be happening with my left breast implant. I had my surgery last October and soon noticed some asymmetry between my breasts mainly when bending over. It almost feels “un attached” when I’m bending over when the other feels more secure. My surgeon hold me that there is nothing that can be done and this is happening because of my skeletal structure. He said over time as the capsule forms hopefully it will be less noticeable but in truth it has become more noticeable over the last several months. Almost a year out from surgery and I’m feeling discouraged with his advice. Any thoughts?

Harry T. Haramis, MD, FACS · Answer

It appears the left implant is intact (doubt ruptured as goes back flat) but flipping in its pocket.

The pocket likely needs to be adjusted- possibly with internal stitches in relation to muscle and may require mesh as well. Since it is 10 months out, not likely to change further.

Further exam and discussion with your/a plastic surgeon is recommended to confirm this.

Gianfranco Frojo, MD · Answer

The implant is rotating within the pocket. This is can be due to several reasons:
1) Over-dissection of the implant pocket
2) Placement of too small of an implant
3) Placement of anatomic ("tear drop shape") implant
4) Capsular contracture (this would create more immobile distortion though)

Darryl J. Blinski, MD · Answer

Based on your series opposed photos, I think best to do a virtual consultation for bed or three-dimensional observation. It appears the capsule in pocket are different and may need revision surgery? Again, best of virtual consult with.

Mats Hagstrom, MD (license on probation) · Answer

To give you a quality assessment we need really good quality information.
This means having access to a complete set of proper before and after pictures and a copy of your operative report.
We need to understand if the implants were placed under or over the pectoralis muscle, and at what level the pectoralis muscle was transected if the implant is under the muscle.
The left breast usually sits higher on the chest wall than the right side.
Most likely there are several things going on at the same time.
We usually assess breast augmentation outcomes with the patient and an upright standing position.
Breast are going to have a very different shape when you lean forward.
This is true, whether you have implants or not.
 Depending on what the ideology is determines how easy or difficult it is to improve your outcome.
Generally speaking your best shot and getting a good outcome is from the first procedure.
I suggest you schedule a few in person consultations with other plastic surgeons in your community.
For second opinion consultations come prepared to bring with you a complete set of proper before and after pictures and a copy of your operative report.
These are part of your medical records that you can request from your provider.
Best,
Mats Hagstrom MD

Strange implant shape almost 1 year out from surgery - will this become less visible or will I need a revision? (Photos)

Answers (4)