When I Lay Down my Chest is Flat and Implants Fall to the Outsides - is That Normal?

It’s normal for the female breast to fall laterally when
patients lie on their backs. This occurs
for a variety of reasons including skin laxity and the combined effects of
gravity and a sloping chest wall.

It’s
not normal for breast implants to fall into the arm pit following breast
augmentation. When this situation occurs
in the immediate post-operative period, the most likely cause is over
dissection of the breast implant pocket.
When this situation occurs late in the post-operative course, stretching
of the implant pocket is the most likely cause.

Regardless
of the cause, this type of severe lateral implant displacement requires
surgical correction. In most cases, this
requires a procedure known as a capsulorrhaphy.
This operative procedure utilizes sutures to decrease the size of the
lateral breast implant pocket and shift the implant in an inward
direction. This procedure is associated
with high success rates and high levels of patient satisfaction.

If
you’re concerned about positional implant malposition, consultation with your
plastic surgeon is appropriate. Your
surgeon should be able to formulate a treatment plan that addresses your
concerns.

This is a good question.
The implants go laterally when you lay down because the pocket has
become too large over time. The implants tend to want to go out to the side
when patients lay down because the chest is round and they are sliding off the
chest.

The good news is that this is easily corrected. As you
mention in your question the pocket can be closed with sutures on the inside so
that the implant is in the proper position. I also usually encourage patients
if they have saline implants to switch to silicone implants, as the softer
implants tend to go out laterally less than the firm saline implants do over
time.

Discuss this with your board certified plastic surgeon as
you have options to improve the appearance of your breasts.