Implant displacement, bad implant placement or will it get better with time? Help please. (Photo)

Op was 6 weeks ago, 310cc HP submuscular. My doctor said I had a wide sternum and pectoral muscle attachment preventing cleavage but my implant starts very far from the middle of my rib cage. It also ends 2/3 of the way towards my back, constantly hitting against my inner arm and looking at the implant from the top, my nipple is not centred on the implant, there is a lot more on the outer sides. Will this sort itself out with time or will I possibly need revision/capsulorraphy/bigger implant?

Doctor Answers 10

Breast Implant Placement

Your photos do not provide us the information to address your specific situation, but here are some basic answers that may apply:

Your muscle is tight and pushing your implant back against the chest wall. Since the pectoralis muscle crosses your chest obliquely this force is pushing the implant outward. As the muscle softens around the implant over the next few months that will improve.

You still have swelling over your breast bone which makes the space between your implants look wider than it will when the swelling is gone. Your surgeon is right in explaining that the implants can only be placed as far toward the muscle attachment to the breast bone allows. The only way to avoid this is to place the implants over the muscle or detach the muscle from the sternum which is never a good idea. It can lead to visible rippling and very distorted looking breasts when the muscle is flexed (worse that what you may already see). Exercises like push ups that tighten the pectoralis muscles are particularly bad in the early stages because of the extreme force that applies to the implant. Once the capsule is fully mature that won't be the case. When you are lying on your back gravity is added to the push the muscle exerts on the implant pulling your implants outward, especially smooth implants which do not grip the chest wall like textured ones do. I encourage my patients to hug their implants toward the center of the chest and to sleep on their side as soon as they can to stretch the muscle as quickly as possible. 

The implant should ideally be centered behind your nipple or the nipple will either be on the inner or outer curve of the breast. If you chose an implant that is wider than your breast and you have a narrow chest it may not have been possible to center the implant because of the muscle attachment and there will be more volume on the sides. 

It is possible that your implants are malpositioned, but that determination can't be made for 4-6 months after surgery. Chances are that many of these issues will resolve with waiting. If not, a capsulorraphy may be necessary, but not a larger implant. That would make the problem worse. Your surgeon wants you to be happy and I am sure he will make every effort to make you so, but you have to give the healing process time to settle out. Just be patient.

San Diego Plastic Surgeon
4.3 out of 5 stars 28 reviews

It is typical of submuscular implants

All your observations are descriptive of submuscular implants.  These can only be remedied with subglandular placement of implants.  

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Implant displacement

Thank you for your question. You are in a healing phase. Give it about 6 months and reevaluate. It will be difficult to comment without seeing prep pictures.

Ven Erella, MD
Austin Plastic Surgeon
4.9 out of 5 stars 30 reviews

Implant position probably a function of anatomy

Thanks for your question and the photos. Without seeing the preop photos it is hard to give accurate feedback. The limit to implant placement medially is the attachment of the pectoralis muscle to the sternum. If the chest wall has a lateral slope then that too can cause the implant to not be as far toward the middle. Once you are 6 months out, you will have a better idea of exactly where the implant pocket will be. Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.8 out of 5 stars 90 reviews

Implant displacement

Thank you for your question. It is hard to answer without seeing your pre-operative pictures. At only 6 weeks you are still early on in your recovery process. It is best to wait a minimum of 3 months before deciding if another surgery is necessary for you to achieve the look you want. I would speak to your physician about your concerns in person. Good Luck!

Bernard Kopchinski, MD, FACS
San Antonio Plastic Surgeon
5.0 out of 5 stars 14 reviews

Post op

hard to answer without preop pics height and weight etc. give it 6 months. let everything settle into place and then adjustments can be made.  sometimes anatomy can restrict what can be done. but be pATIENT FOR NOW

Jonathan Saunders, MD
Newark Plastic Surgeon
4.7 out of 5 stars 64 reviews

Displacement or Bad Implant 6 Weeks Following Op

It's difficult to determine your possible situation with the photos provided and without an in-person exam. 

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 still early into your healing  and it can be up to one year see your final result which is why it's best to wait 6 to 12 months depending on the reason for #revision. Matters such as sagging or drooping  and size change will not improve with time. You must have patience, but if there are any causes of concern, ask questions of the doctor or the nursing staff.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

6 weeks post op


On the one hand, at 6 weeks post op your breasts will still soften and settle into place more over the next few months. However, the only way to truly assess if you have a placement problem right now is in person with your Plastic Surgeon. I recommend that you contact them and ask to be seen in person.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Implant placement

Hello, it is possible for implant position to change for months so it is usually worthwhile reserving judgement on the result in the short term.   If you still do not see improvement you could discuss management options with your surgeon.

William Andrade, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 62 reviews

Breast Augmentation Recovery

Hang in there! As long as the shape and feel are improving week to week, however slowly, there is still hope for the final outcome. Ask you plastic surgeon if there are any compression garments, stretches or massaging exercises that can help speed your recovery.

Clark Schierle, MD, PhD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 23 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.