Pocket Stretched 6 Months After Breast Implants

Question

I got implants underneath the muscle six months ago, now the pocket in my left breast has stretched. What can be done. It is causing the implant to fall underneath my arm when I lay down

Otto Joseph Placik, MD · Answer

This is a difficult problem to predict and therefore, prevent. Some patients are more prine to this problem and certainly larger implants can exacerbate this tendency. A revision may be required as well as long term use of nocturnal support garments to prevent recurrence. Textured implants could help but have their drawbacks.

Richard Baxter, MD · Answer

Since the muscle covers the top and inner portion of the implant but not the outer part or bottom, occasionally the muscle essentially pushes the implant down and out. It is usually repaired by sewing up the pocket surgically. However, if your tissues are thin around the implant, the stitching may not be enough to prevent it from recurring. In that case a reinforcing graft with a material called Strattice will be helpful: www.renewingyou.com

Scott C. Sattler, MD, FACS · Answer

From the description, it sounds like you dislike the position of your submuscular implant when you are lying flat- the implant slides off your chest into your armpit region. It could be the case the outside portion of your implant pocket was made too large, allowing the implant to displace too far to the side. Without a photo, this is all conjecture. If the problem really bothers you, I'd recommend waiting about 12 months for the implant capsule to thicken, and then consider a lateral capsular repair (capsulorraphy) and a medial capsulotomy with some additional muscle release to centralize the implants. 

	Check out the weblink below for an example of this problem.

Steven Wallach, MD · Answer

I fh te pocket is too large a capsulorrhaphy can be performed to tighten up the pocket laterally so that the implants do not migrate too far laterally.

Nick Masri, MD, FACS · Answer

It happens much more than expected. The breast implant may move laterally to an area where the muscle does not cover it. In some cases this is caused by excercise. the pectoralis muscle pushes firmly on the implant. The skin may then stretch just enough to allow the implant to slip through. It may also be caused by inelastic or sagging skin not lending enough lateral support. Surgeon error may also be to blame . It may be that there was an over agressive dissection of the pocket.

Nonetheless there are surgical options to treat this issue. They usually involve closing the implant pocket with a series of well placed stitches. It really depends on how much lateral excursion there is and the conditon of the skin and the muscle surrounding the implant.

Nonetheless there are surgical options to treat this issue. They usually involve closing the implant pocket with a series of well placed stitches. It really depends on how much lateral excursion there is and the conditon of the skin and the muscle surrounding the implant.

Peter E. Johnson, MD · Answer

Implant position raises frequent questions on the web, and the implant pocket, especially to the side, can stretch out and the implant can appear to slide off the chest when you lie on your back. The best results occur when the implant remains centered on the nipple and moves hand in glove with the breast. If the pocket is too large, or too far to the side, the implant can slip in the pocket. When the implant and pocket don't fit, the capsule can be repaired by a process called capsulorhaphy to tighten the pocket and center the implant. Such repairs can work well so ask your surgeon about it.

	Best of luck,

	peterejohnsonmd

Scott E. Kasden, MD, FACS · Answer

The pocket can be surgically corrected. This involves suturing the pocket to close the stretched area, which in your case is lateral, so as to centralize the breast implant. This is not as big an operation as the original one, but it is real surgery.

Robin T.W. Yuan, MD · Answer

Pockets and capsules are notoriously difficult to control. If it is severe enough and bothersome enough, an internal capsulorhaphy or tightening can be done or a neo-pocket created by a re-disccetion of a new pocket.

Richard P. Rand, MD, FACS (retired) · Answer

The pocket that is stretched too much can usually be repaired with stitches. Some people have outwardly angling chest walls and are more prone to this than others. Salines are also more prone to this because the capsule they generate is usually thinner than that around a gel and less supportive of implant position.

John Whitt, MD (retired) · Answer

Any displacement of breast implants outside of their originally designed pocket can be a difficult problem to correct. This can be treated with a capsulorraphy which involves excision of a portion of the capsule and closure to attempt to obliterate this area. If this fails, the use of acellular demal matrix (eg AlloDerm) can sometimes be of benefit, but this adds additional cost.

Pocket Stretched 6 Months After Breast Implants

Answers (10)

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