What is the solution to enlarged breast pockets from implants?

After 10yrs of saline full "C" implants (born with B) my boobs would flatten while lying down/implants would slide towards arm pit. Had different plastic surgeon replace implants with "D" silicone (I was in between bra sizes with full C) & added sutures to my pockets in a "J" pattern which lasted 1 year. Left is sliding again. Is this fixable? How do I choose the 3rd Plastic Surgeon?

Doctor Answers 6

What is the solution to enlarged breast pockets from implants?

I am sorry to hear about the problem you are experiencing after breast augmentation/lifting surgery. Based on your description and pictures, it seems like you are experiencing a breast implant displacement problem.
Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline. Doing so will prevent the breast implants from migrating to the sides when you lie down and will help centralize the position on the breast mounds. In my practice, this repair is done with a 2 layered suture technique. The use of acellular dermal matrix is an option ( although not usually necessary) especially if significant implant rippling/palpability is present.
 
I hope this, and the attached link (dedicated to lateral breast implant displacement concerns) helps. Best wishes.

Implant Malposition

Thank you for your question. I assume that your implants are placed under the muscle. If this is the case, then the natural tendency for implants is to move towards the armpit. Your second plastic surgeon performed the correct surgery by trying to medialize the breast pocket. Depending, this can be performed with stitches that are permanent or not, and can be reinforced with additional tissue substitutes - like allomax / alloderm - to help secure them in place. So, to answer your question - yes, this is fixable. If this is something that truly bothers you and you desire to have it fixed, you may want to ask your Plastic Surgeon about placing textured silicone implants - these implants can adhere and stick a little better within the pocket and may have a tendency to slide less. Overall, if you have a good relationship with your PS, I would consider sticking with him or her; what they did was appropriate, and sometimes repairs fail. Best of luck! 

Breast Revision for Large Implants

I have seen with this problem quite a bit and as you mentioned the pocket and likely the surrounding soft tissues are inadequate to hold the implant in place. You will need to down size the volume of your enhancement, use your own capsule and some additional supportive material such as strattice to act a an "internal" bra. This will hold the implant in place and hopefully reduce the footprint of the breast by narrowing the lateral border. Wishing you the very best!

Bahair Ghazi, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 34 reviews

Breast implant malposition

 As a plastic surgeon who does a lot of breast revisions I would recommend at this time you give added support by using an 8 x 8 piece of stratus along the lateral gutters on both sides. Since the Stratus does not stretch and it seems that your capsule does this'll make it for a better likelihood that this will not recur a third time. Try to find a plastic surgeon in your area with experience in breast revision. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Lateral Malposition

I do a LOT of breast revisions and there are ways to use the capsule which surrounds the implant and help hold the implant in position.

However this is often not enough to keep it there and additional scaffolds or support is required.

It is very important to seek out not only a board certified PS but also one that does a large number of breast revision surgeries.

All my Best!

Dr B

Bradley Bengtson, MD, FACS
Grand Rapids Plastic Surgeon
4.8 out of 5 stars 44 reviews

You do have options

Some degree of lateral inaction must be tolerated and some may not be able to be corrected due to anatomy or habit (like sleep position).
i have had great success with this problem using neo-sub pectoral pocket.  Using a textured breast implants will also help.
Best Wishes,
Nana Mizuguchi

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 45 reviews

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.