Not Happy with Implants. Over Muscle Low Profile; Have Slight Sagging and Uneven?

I had implants done to fill deflated breasts, I asked if I would need a lift. I was told my nipples were in a good position relating to the bees fold etc. I had over the muscle placement low profile 350cc as advised. My breast tissue sags slightly underneath the implant and one is higher and rounder than the other. I've gone back twice but been told to wait till they settle now they are a year old. I can feel the whole implant it pokes out in the cleavage & visable rippling. What happened???!

Doctor Answers 6

Concerns after breast augmentation

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While it is impossible to draw any definitive conclusions without the benefit of photos and an exam, your question brings up some key points relating to breast augmentation.  

1. Putting implants above the muscle is not a substitute for a breast lift.  If a woman needs a breast lift, placing the implants in a pocket above the muscle is not a going to correct the sagging skin and breast tissue. 

2. I am assuming that you have saline implants.  Saline implants above the muscle can lead to visible rippling.  This is especially true in women who have thin tissues (skin and fat under the skin) and little breast tissue to begin with. 

3.  If your breasts were asymmetric before the surgery (another assumption), they most likely will be after surgery as well.

4. If a year has passed, and you still think your result is unsatisfactory, you may very well need a revision.   The problems you mentioned will not resolve on their own. 

I would recommend that you go back and speak to your PS and consider consulting with another Board Certified PS as well.

Best of Luck,

Dr. Weider 

Dallas Plastic Surgeon
5.0 out of 5 stars 102 reviews

Implant issue

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You are probably right in that you probably needed a lift.  A lift can change the breast envelope and tighten the breast to give you more youthful look. I suggest you have someone near you examine your breast and perhaps consider revising your surgery.  Also, it might be possible that you can just have a lift done with your existing implant left in place.  Good luck.

Dr. Vasisht

South Shore Plastic Surgery

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 94 reviews

Concerns after Breast Augmentation?

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Unfortunately, without direct examination and/or viewing pictures it is not possible to give you precise/meaningful advice. You may benefit from additional in-person consultation  with your plastic surgeon and/or with other well experienced board-certified plastic surgeons in your area. You should have some peace of mind that significant rippling/palpability of breast implants as  well as significant breast asymmetry can often be  greatly improved with revisionary breast surgery  techniques.

Best wishes.


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Rippling can happen because the tissues are very thin. You m ay need strattice to camouflage the implants. If they are above the muscle they can go below.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Sagging, Rippling, Uneven Breasts - What Happened?

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Dear Claire, The complete answers to your questions require some questions on my part.  For the purpose of this internet discussion, I will make some assumptions.  First of all, I will assume you have saline implants and you have low body fat.  Rippling, while possible in silicone implants, is very rare.  One of the big problems with saline is that it ripples more often than not.  Unfortunately, you have discovered some of the problems of going over the muscle.  Sometimes, you can see the edge of the implant, especially in the cleavage, and it is even possible you are starting to get a capsular contracture since under the muscle covers the implant better, decreasing the ability to see it, and it also decreases the possibility of a capsular contracture.  While there is certainly nothing wrong with low profile implants, in my practice, I am pretty much 99% high profile implants. 

As far as one implant being higher than another, this more than likely was your anatomy.  If your anatomy was even pre operatively, than the higher side may be a capsular contracture because all capsular contractures round up.  That also may be why one breast is rounder.  

It's been a year.  It is time to ask your plastic surgeon to consider a revision.

Dissatisfied with breast surgery

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A photo (before and after) is needed to help advise you on your issues.  An exam would be better...why not discuss your problems with your surgeon?

Leonard T. Yu, MD
Maui Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.