Why are some implants still high years later in cases without mesh/internal bra?

The most common reasons for hight implants years after surgery are capsular contracture, restrictive tissues within the breast (most common in tuberous breasts and with total muscle coverage), and implants that are too large for the patient's breast/frame.

Dear magicskymagic,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Dear magicskymagic,

Thanks for your excellent question about breast implants. It's natural to wonder why some implants stay high, even years after surgery, without the use of mesh or an internal bra.

While it's true that implants placed behind the muscle usually settle and become lower over time, not everyone experiences this to the same degree. Some implants may remain high because of a too-small or too-tight pocket, or if they were placed too high during surgery. Other factors like a patient's unique anatomy can also play a role.

While mesh or an internal bra can help prevent the implant from settling too low, it's not necessary for everyone. Each person's body is unique, and a skilled plastic surgeon will evaluate their specific anatomy and goals to determine the best approach for achieving their desired outcome.

I hope this response helps address your concerns.

Best regards,
Dr. Katzen