Are my breast implants too wide for my frame? Are they to far apart? I'm 8 months post op. (photos)

Question

I'm 500cc mod plus profile silicone mentor, 8 months post op. My breast continue to sag and are drifting more towards my armpits. I have no cleavage without a bra, I have a HUGE gap between my breast. I also have skin that is sore and pulling in between my breast. I'm going back to see my PS for a possible revision. These just don't look right to me.

Ram Kalus, MD, FACS · Answer

I agree with my colleagues. Bottom line, you are not happy, and you are correct that your breasts look artificially round. Visually, they are too large, too round, and over-projecting for your frame. There are many implant choices averrable today including shaped (anatomic) that provide a much more natural upper slope. If they are slipping laterally, they are probably smooth implants that have slowly migrated. If you are very physically active and do lots of push ups or pectoral presses, this can make the situation even worse. Your best bet is to return to your plastic surgeon and articulate your concerns, and be very specific about how you feel your breasts ought to look. Hopefully he or she can can accomplish the desired correction for you with revision surgery.  In my own practice, for example, I ask patients to send me "favorites" and I use those photos when I perform their surgery so that the desired endpoint is well known both to me and to my patients. Your current size might intact be there result of what you told your plastic surgeon, but in my opinion (and apparently yours now) they are not the optimal implant for you. Depending on the patient's anatomy and what she is hoping to achieve, we make the section of the best implant.There are more options today than ever before and your plastic surgeon can review all of them with you. Best of luck to you.

Don W. Griffin, MD · Answer

You have fairly large implants and very thin tissue. This is a perfect setup for implant pocket stretching which causes the implant to fall to the sides when laying down. This can be corrected surgically by closing the pocket laterally and reinforcing the closure with a mesh material. Smaller implants would also help prevent it from recurring.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, by your pictures it look like your implants are above the muscle and you have lateral displacement.  Please discuss your concerns with your plastic surgeon. Good Luck.

Adam C. Augenstein, MD · Answer

You should follow up with your surgeon closely whenever you have a question about your result. Some patients experience displacement of their implants toward their armpits over time, and this is due to stretching of the pockets. This can be most noticeable when you lay on your back. It is difficult to tell from the photos if your implants are too wide for your frame. Revision surgery of the implant pockets may be necessary to correct this, but best to follow up with your surgeon.

Steven Wallach, MD · Answer

Cleavage is determined mainly by your anatomy.  However, your implants do fall off to the sides quite a bit when you are lying down. This may be able to be corrected with pocket repairs.

Victor Ferrari, MD, FACS · Answer

Sorry to hear about your problems.  By what you've stated and the photos you've shown, it sounds like your breast implant pockets are getting stretched out laterally.  It could be from the weight of the implants as you lay on your back or it could also be due to exercises.  For example, if you are doing any exercise that involves forceful pectoral muscle flexion (bench press, push ups, yoga, Pilates, etc), your own pec muscle could be pushing the implants apart causing an increased cleavage.  Talk to your PS about this and what you can do to modify your workouts or maybe wear a bra at night.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery. It is difficult to give you specific advice based on the photographs (arm elevation may change position of the breast implants on your chest wall). Based on your description, it sounds like you may be dealing with a breast implant displacement problem. My best suggestion: follow-up with your plastic surgeon but make sure that, if considering revisionary breast surgery, that he/she has significant/demonstrable experience helping patients with revisionary breast surgery. In other words, ask to see lots of examples of his/her work helping patients in your situation. I hope this, and the attached link (dedicated to  revisionary breast surgery concerns) helps. Best wishes.

Are my breast implants too wide for my frame? Are they to far apart? I'm 8 months post op. (photos)

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