Implant Problem- One Breast Falls to Side

Unfortunately this is a very common problem with dual-plane subpectoral techniques.  These techniques offer no lower and lateral support to the implant and subject the implant to variable but constant force in the down and out direction by virtue of the altered pectoralis muscle.  This is the reason that I prefer the subfascial plane for both primary and revisional augmentations.  I developed a modification I call COLD-SUBFASCIAL augmentation in which I am able to protect the fascia from damage and use it to offer lasting support and shape a beautiful tear-drop natural appearing breast.  Other options such as capsulorrhaphy and alloderm slings tend to stretch and lose support.  By leaving the muscle out of the equation the large force pushing the implant toward the implant is removed.  I hope this helps!

 

All the best,

 

Rian A. Maercks M.D.

If an implant falls too far to the outside when you lie down then there may be too little support for the implants laterally.  If you are early in the healing process from implant surgery then you may be able to support this area so that your tissue will grow together and prevent the implant from falling off to the side.  If this doesn't work or if it is too late to try this conservative measure then the problem may be corrected with surgery.  This usually involves using two or three layers of stitches inside the breast pocket to close off the outer portion of the pocket and give it strength and support.  Eventually, your tissues will heal as well and add additional support so that the implants don't slide off into your armpits anymore.

Breast implants that fall off to the side, can be caused by several things. One, the pocket for the implant was opened too far laterally, or the shape of the chest wall is like an A frame house, allowing the implants to fall to the side.

Prior to breast surgery , it is important to measure the breasts in the standing and lying position and note any asymmetries. Once noted, a surgical plan can be developed to help correct these asymmetries. Most often there will still be residual asymmetry.

If implants fall off to the side, it is possible to close off the pockets with a procedure known as a capsulorrhaphy, this however, requires additional surgery.

Thank you for the question.

One of the most common complications after breast augmentation surgery is implant mal-position. This occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (“riding high”), inferiorly (“bottoming out”), medially (“symmastia or uni-boob”) or laterally (falling outward into the axilla).

In your case, you may be experiencing  lateral displacement of the breast implant on the right side. This may be associated with discomfort along the side of the right breast. This can be corrected using an internal suture technique decreasing the size of the pockets and moving the implant toward the midline.

Please make sure you're working with a well experienced board-certified plastic surgeon and ask to see results of patients who have had similar surgery performed.

I hope this helps.

 

If the new implant falls off to the side, this is an implant pocket problem.  From what you stated, you likely had some component of a capsular contracture of the right breast.  Without knowing more details of the revision procedure, attempted treatment of your "asymmetry" and "dent" may have led to this new problem.  I'd also be curious to know how much of a size increase you experienced.  Regardless, this issue needs quick attention in case a nonsurgical intervention could help.    

An implant sliding out to the side too far may mean the pocket is too large in that area.  Seeing your surgeon early may permit taping and other techniques that can help to get the pocket to heal in a way that provides better implant positioning.  It doesn't always work, but if it's going to it has to be done early.

It is discouraging when revision of breast implants does not solve all problems, and the after four weeks if the implant falls off to side it seems that the pocket is too large allowing the implant to slip out of position. We don't have enough information to know just what was done, though at best you might try to stay in a snug bra 24/7 to hold the implant centered in the breast, and let your surgeon have a look.

Best of luck,

peterejohnsonmd

Alexandrite, you mentioned that you are 4 weeks post-op and are noticing some lateral movement of the implant  while lying down.  Did you have this before surgery with your previous implant?  If the movement is subtle and there appears to be no other problems with the position of the implant then the use of supportive bras and restriction of activity might be helpful.  If this problem is more severe, then you might need surgery.  It is best to speak with your plastic surgeon as soon as possible.

Having your implants go up towards your armpit is a bit of a concern. You should see your surgeon ASAP.

I'm very concerned, please call your surgeon TODAY to be seen first thing in morning. Also please give us follow up.