Breast looks like it slides to the side (toward armpit) when laying on back (Photo)

Question

400cc silicone implants under the muscle. 9 months post opp. Is there anything I can do to correct the look in the cleavage area on the left breast? It looks pretty normal when sitting up, almost like there is a shadow of the debt that appears when I lay on my back. When I push the breast in with my arm, it looks like it resolves the issue.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. The pocket that implants live always seems to get a little larger allowing breast implants to drift somewhat toward the armpit when one lays down. Your implant position while lying down looks reasonable. Natural breasts that are reasonably sizable also do the same thing when one lies down. I would not recommend any treatment for your concern.Best wishes.

Matthias Solomon, MD · Answer

Some displacement to the side is normal with shifting of the implant(the implant does not move but the gel shifts). However, in your case, it appears the the implant is moving to the side due a pocket that is too large. You need a consultation to verify that this is indeed the problem. Only way to correct this is revision surgery. However, this is not something that needs to be corrected unless it really bothers you.

Robert D. Wilcox, MD · Answer

Dear Sarnoult21,
  
 
  
Recognize that whether a woman has had breast augmentation or not, it is natural for the breast tissue to fall to the side slightly when supine.  When it becomes excessive, this is because the pocket has stretched too far laterally, allowing the movement.  A surgical correction can be done most simply by Bovieing the inside of the capsule, although that can recur.  The other way is to close down the lateral extent of the pocket with sutures from the underside of the skin to the chest wall.  A final option would be to replace the smooth implant with a textured one and use a drainage tube for suction for one week to get it to adhere in place.  I hope this has been helpful.

Kiran Polavarapu, MD · Answer

Congrats on your recent surgery. Breast implants should feel natural and can  have some movement. If the implants are laterally displacing. causing you discomfort or rotated (if they are shaped implants), you should talk to your surgeon about options for revision. Although your photos are limited, they do look natural and not excessively displaced.

Curtis Wong, MD · Answer

but if not excessive, its best to leave it alone.  If literally to your armpits and causing distress, revisions can be done and consideration may be given towards textured shaped implants to fix the implant position better but  if it doesn't heal perfect, could lead to rotation issues and malposition.  Your photos show something completely 'normal'.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery. You demonstrate your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients. This phenomenon is called lateral displacement of the breast implant. Surgical correction is an option.
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.   In my practice, I use  a 2 layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option (although not usually necessary)  especially if significant implant rippling/palpability is present.  
 My best advice: select your plastic surgeon carefully. Make sure that he/she has significant experience achieved the types of outcomes you will be pleased with. Then, communicate your goals carefully, as well. Working together you will come up with a good plan to achieve your goals. You may find the attached link helpful to you as you learn more.   Best wishes.

Brooke R. Seckel, MD, FACS (retired) · Answer

Congratulations on your breast augmentation.  The discomfort that you describe is called lateral displacement and occurs when the breast implant pocket extends too far to the side.  This can be corrected with a surgical revision.  It is best to discuss this in person with your plastic surgeon.  For more information please read below:

Breast looks like it slides to the side (toward armpit) when laying on back (Photo)

Answers (7)

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