Is This Lateral Placement of Silicon Implants? (photo)

My plastic surgeon has said he is going to do a revision as my implant has been off to the side since day 3 post op. It moves more to the side with some movements and I have a burning pain at times as well . 350cc Silicon, w/ mastopexy and full tummy tuck on 9/28/2011. 2/14/12 is my revision should I have to wait this long, I hurt and he knows and just says,"its going to hurt". He doesn't spend much time answering questions or asking what I want them to look like either. Is this lateral placement?

Doctor Answers 8

Lateral Breast Implant Malposition?

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Thank you for the question and pictures.

Yes, it appears that your breast implant has displaced laterally and inferiorly;  this can be corrected using a internal suture repair technique (capsulorraphy).  Your surgeon may be waiting to allow for thickening of the breast implant capsule to occur ( a thicker breast implant capsule may “hold” suture better  thereby  decreasing chances of breast implant malposition recurrence).

Best wishes.

Breast implants outside the breast boundaries

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The photos illustrate that the breast implant is outside of the boundaries of the breast.  This problem should be corrected before the displacement of the implant causes a permanent capsule to form to the side of the normal breast shape.

It will be much more difficult to correct this issue once this happens.  Revision  will require a capsulorraphy (closure of the space where the capsule has formed),  possibly with the use of additional support material like Alloderm or Strattice.

Mario Diana, MD
Plano Plastic Surgeon

Still waitng for breast implant revision

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It is clear from your photos that the implant is out to the side of and under the breast, not a very pretty picture. The malpostion may not cause pain, though it is clear that the surgery has gone awry. Seems odd to us what the delay is about, and most of us would not want to see our patient languishing out there waiting for help.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Revision after augmentation-mastopexy

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The simple answer to your question is that your silicone gel-filled breast implant was not placed properly behind the breast and/or did not heal in the proper position and is laterally displaced. It is much more difficult to know if this is what is causing your pain problems and whether correcting the implant position will solve the pain issues. It's also difficult to know when the tissues are healed, recovered, and stable enough to allow for a correction of the pocket around the implant which is not a simple correction. 

It is not of help to you at this point but this is why an augmentation-mastopexy is difficult to do at one operation and get everything to heal properly without the need for a revision. Many plastic surgeons would have done a mastopexy without the implant and without the "Wise pattern" or horizontal scars and then done the augmentation with implants later if still needed or desired. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Implants and Breast Lifts at the Same Procedure

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Many plastic surgeons refuse to do a breast lift and a breast augmentation at the same surgery because it is moredifficult to get a precise match up of the breast gland and the implant than when they are done at separate stages.  There is about a 20% rate of reoperation when the two are combined because of biologic unpredictability, not surgeon's technical error.  I do breast lifts and implants at the same time, because that saves 80% of people from having a two stage procedure.  When revisions are done, it is usually wise to wait to let tissue settle.  Six months is a typical time to wait for correcting implant position. I am sure the wait is very frustrating, but  your patience may be rewarded with a better outcome.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Breast Implant Malposition

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Thanks for including the photos, they are very helpful. Your breast implant has moved outside of the natural boundaries of the breast. This creates a visual deformity and often a pain as you mentioned. It requires surgical revision. It is unfortunate that surgery is not always perfect but revisions are sometimes required. The surgery requires tightening of the scar tissue around your implant and I think your doctor is waiting until it matures and gets strong enough to hold sutures so they don't tear through. It will help if you wear a bra with wire support to hold the implant in better position and some type of soft padding over the outer edge of the breast, in the bra, to help push the implant back towards where it belongs. the good news is that your surgeon will be able to correct this soon.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

About Breast Implant Displacement

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During breast implant surgery a #pocket is created carefully to maintain certain folds on the sides and bottom of the breast. Occasionally, the space for the breast implant becomes too large on the #side of the chest or the tissue stretches and the implants fall too much to the side. This is most easily seen when the patient is lying on her back. At times, the implants can move towards the patient’s armpit.

Treatment will generally require closing the space with a procedure called a #capsulorrhaphy. In this case, the capsule is closed off internally much as we do when we are trying to raise the breast fold. The capsule is closed with sutures and at times Acellular Dermis Matrix (#ADM) or other soft tissue substitutes would be used to further support this correction. 
However, it is best to consult with your Plastic Surgeon to better determine with an in-person exam.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Breast implant displacement

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It looks like the implant may have descended below the fold and laterally. This can usually be fixed with pocket revisions.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.