Should I have my implants taken out and placed over the muscle instead? (Photos)

Question

when lift my arm my nipples go so high up that it’s very unattractive to me.. i’m also now experiencing slight pain when i wear a bra in my right breast.. i also feel like my right nipple has now shifted to the side whereas before they were pretty even. do you think it’s because of the size and where i had them placed? would anyone suggest going over the muscle and possibly a size smaller? would my now stretched out skin be ok to go the route of over the muscle? help?!

Donald R. Revis Jr, MD · Answer

Good morning!
You do have a significant amount of bottoming out, which is the most common condition I treat when performing revisions. I see it about 5-6 times a week. Bottoming out basically 
means the tissues are stretching out, allowing the implant to slide down
 your chest wall. My 
correction is the Internal Bra, my strong permanent internal suturing 
technique which tightens up the pockets and corrects the bottoming out. I have attached a link to my Breast Augmentation Revision / Internal Bra photo gallery for your review- hope it helps!

Tom J. Pousti, MD · Answer

I am sorry to hear about/see the problems you are having after breast augmentation surgery. I think your concerns are appropriate; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”).  
It is possible that you are feeling the implants significantly along the lower poles of the breasts. Patients in your situation often complain of discomfort in the area of implant malposition. Also, consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low. 
Generally, signs of breast implant bottoming out include: 
1. Breast implant "sits" too low on the chest wall.
2.  Excessive palpability or visibility of the breast implant along the lower breast pole.
3.  Nipple/areola complex seems to be sitting relatively high, because the breast implants have settled too low. 
4. Discomfort along the lower breast pole (secondary to pressure from the underlying implant).
5. Relative paucity of upper pole breast implant volume compared to lower pole volume.
6. Increased visibility of a infra mammary fold scar (higher on the breast mound).
I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy (internal suture repair). Sometimes, depending mainly on the patient's history and physical examination, I will also use additional supportive materials such as acellular dermal matrix or biosynthetic mesh. This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes and visibility of the inframmammary fold scars should improve with this operation.There are many potential downsides associated with conversion of breast implants to the sub glandular position; I would not recommend that you do so.My best advice: seek consultation with a few board-certified plastic surgeons who can demonstrate significant experience (with this type of revisionary surgery) achieving the types of outcomes you will be pleased with. Then, communicate your goals carefully as well.  Working together you will come up with the best plan to  achieve an outcome that you will be pleased with.  Best wishes.

Michael C. Edwards, MD, FACS · Answer

Your breast implants are sitting too low causing your nipples to be to high. This can be repaired by internal suturing, possibly supported by a synthetic mesh. I would encourage you not to have them changed to above the muscle because your are a thin woman and I think you would be unhappy with the result. You need to be cared for by an experienced board-certified plastic surgeon but this can be improved for you.Dr. Edwards

Karol A. Gutowski, MD, FACS · Answer

Based on your pictures, you seem to have a crease in the lower breast and the implants seem to have dropped down. A pocket revision or a new pocket may be needed. The right nipple will stay the same.

Jon A. Perlman, MD (retired) · Answer

Your implants have unfortunately dropped down to a degree that's causing deformity in part due to placement of too large an implant for your chest size.  I would recommend capsulorrhapies and probable exchange to a smaller implant to decrease the weight and tension on your tissues.  The improvement can be dramatic and should be considered.  Best wishes Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

Should I have my implants taken out and placed over the muscle instead? (Photos)

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Answer: Should I have my implants taken out and placed over the muscle instead?

Answer: Should I have my implants taken out and placed over the muscle instead?

Answer: Should I have my implants taken out and placed over the muscle instead?

Answer: Should I have my implants taken out and placed over the muscle instead?

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Everything you need to know about Breast Implant Revision

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Should I have my implants taken out and placed over the muscle instead? (Photos)

Answers (5)

Answer: Should I have my implants taken out and placed over the muscle instead?

Answer: Should I have my implants taken out and placed over the muscle instead?

Answer: Should I have my implants taken out and placed over the muscle instead?

Answer: Should I have my implants taken out and placed over the muscle instead?

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.