It would be helpful to see photos of you from the front with your arms down to determine if implant position looks concerning. I recommend that you visit with your Plastic Surgeon in person to share your concerns and have them examine you.
All the best
Lateral displacement of the implant may have occurred.
you for your question and photos. To ensure a natural look, breast implants
should be centered directly behind the existing nipple. Because nipple location
will vary from patient to patient, where the implant is located on the chest
wall will vary accordingly. Wide set nipples will result in the implants being
closer to the armpits than nipples that are closer together. Visit your surgeon
to see if lateral displacement of the implant has occurred. Luckily, if lateral
displacement has occurred, your surgeon can explore corrective options with you.
You should address any concerns or questions you may have with your chosen surgeon.
Your pictures make it difficult to tell whether your implant position is normal when upright, and you are simply more aware of your "side boob" with larger breasts, or whether the pocket has expanded laterally allowing your breasts to fall laterally, or whether they are not optimally positioned. Some patients do benefit from a lateral capsulorraphy, and pocket revision which is quite successful. I would discuss further with your surgeon, and if not satisfied with the answers, get a second opinion.
Thanks for writing,
The implants have migrated onto the lateral chest wall. The pocket needs to be closed, sometimes we use acellular dermal tissue to act as an internal bra.
Stephen M. Dvais, MD, FACS
Gren Hills Plastic Surgery
We can't tell exactly from the views you have sent us, however the implant should be centered within the breast under the nipple. When on your back the breast may fall to the side a bit though the implant should remain again within the breast envelope centered on the nipple. If not have your surgeon take a look.
Your Thin, The Pictures Are Not The Same As Being Examined
Your pictures with you arms up are hard to analyze. You seem to be thin and you do not have a lot of subcutaneous padding over your implants. It could very well be that your implants are slightly to the side on your rib cage, but this depends on the position of your breasts and nipples, the curvature of your ribs and the size of your implants. There are many factors
A physical examination is really the only way to decide if a revision is best for you. On thin women like you it can be difficult to do surgery and make minor changes of the pocket position.
Gordon Telepun, MD
I'm sorry to hear about your concerns after breast augmentation surgery. 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.
I hope this, and the attached link, (dedicated to lateral breast implant displacement correction) helps. Best wishes.
The center of the implants should be centered behind the nipple areolar complexes. If they are not, they may have been placed to far laterally. This would require surgery to try to correct, by closing and reinforcing the lateral pocket to shift the implant(s) more medially (towards the center). If the implants are too big and wide for your chest and breast dimensions, then a high profile, which is more narrow, but projects more, can be used.
Thank you for your question and series of photographs. There are two common reasons for an implant to be localized too far towards the armpit - either the implant itself is wider than your chest width, or the implant pocket was created too far towards the side of your body. Voice your concerns to your surgeon as the implant should be centered behind your nipple and areola for proper placement.