When I lay down I have at least a hand between the space ! Any suggestions? (photos)

I got my surgery November 6, 2015 silicone small D. Before I got breast implants i was a B I never really had cleavage and when I laid down I was completely flat. After I got my surgery I'm obviously more round and fuller but I don't have cleavage I have more then I did but not how I expected. When I lay down I have a huge space between my breast since they seem to go to the side into my armpit sort of. Is this normal to have so much side boob?

Doctor Answers 7

Lateral displacement

Thanks for the question.  It is hard to say without seeing your preop photos.  Most likely, you had that gap before surgery and now it is just amplified.  During a breast augmentation, it is unusual to change the breast footprint itself.  The medial cleavage can be altered but it usually requires extensive maneuvers to do that.  It also may be the implants are large and the pocket is starting to stretch laterally which would need to be corrected with surgery.  

Good Luck

"The above answer has been given without seeing this patient and cannot be substituted for actual in-person examination and medical advice; it is only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Cleavage after Breast Augmentation Surgery

Thank you for a commonly asked question in my practice. Cleavage depends on many factors. the most important one is you anatomy. When patients have a round chest cavity, also known as pectus carinatum (barrel chest) the natural tendency of the breast is to be lateralized (falling to the side). This anatomical presentation can not be changed with out radical surgery and is not done. When undergoing breast augmentation procedure you will increase the volume and projection of your breast so you will improve your cleavage appearance but will need a good bra to decrease the distance between the medial position of your breast. As you lay down the natural motion of the breast is to fall to the side and even more so with your breast. When getting large smooth round implants they will require a larger pocket and will cause the implants to fall side was creating a large separation that you are describing. In order to correct that you may need to have the implants changed to smaller or different profile implants with correction of the lateral part of your implants pockets. Another option is to retreat the pockets and change your implants to textured implants that do not move side ways.

Hope that helps!

Good luck!

When I lay down I have at least a hand between the space ! Any suggestions? (photos)

You had wide set breasts before the implants. Thus adding volume will only increase that issue. You should have been explained that BEFORE your surgery!

Lateralized breasts

 It is not uncommon, especially in women with a slanted chest wall away from the midline, that gravity over time, will stretch the lateral pocket, which is on the side, more than the one towards the cleavage. This will require a cinching up of that pocket with either sutures or adding a nonstretchable substance like Strattice. Go back to your operating surgeon to discuss. L

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.6 out of 5 stars 38 reviews

Lateral Breasts

Thanks for the question. It is hard to assess this without and exam and without seeing preop photos. It does appear that your implants have settled a little lateral and low. You should be evaluated by a board Certified Plastic Breast Surgeon that does many breast surgeries and revisional breast surgeries. This could possible be fixed without having to change your implants with a pocket tightening technique such as "popcorn capsulorrhaphy". You should be evaluated by a Board Certified Plastic Surgeon. Best Wishes.

M. Bradley Calobrace, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 39 reviews

Lateral Breast Implant Displacement...

Thank you for the question and pictures. You demonstrate your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients. This phenomenon is called lateral displacement of the breast implant; it may be of concern from the visual and the discomfort standpoints. Surgical correction is an option.

Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline. In my practice, I use a 2 layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option ( although not usually necessary) especially if significant implant rippling/palpability is present. Also, the use of a larger/wider breast implant may help improve/decrease the space between the breast implants. Based on your photographs, I think that your concern is areola size; areola reduction surgery may be necessary to achieve your goals.

I hope this, and the attached link (dedicated to revisionary breast surgery concerns), helps. Best wishes.

Too much side boob?

Thank you for your question.  Motion and position of implants is something that is different for every patient and there are a few things that need to be taken into account.  

The implant chosen makes a difference- smooth implants tend to shift more than textured implants.  Also important is the width of your sternum and the shape of your chest wall.  These two factors tell your surgeon where he/she can put your implants safely and how they will sit on your chest.  If your ribs slant backwards, your implants will tend to move outwards as you lay down.

I would recommend bringing up these concerns with your surgeon- if he/she thinks that your implants are moving outwards more than they should, there is a small surgical procedure that can be done to help fix the problem.

Good luck!
Dr. Seth

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.