Drooping of Breasts and Implants Plus Stretch Marks 5 Months Post Op. Very Unhappy, What Are My Options?

I had implants 4/11, I am 5 months post op, and noticed a gradual "drooping" between 3 & 5 months post op as well as awful stretch marks....my surgeon recommended the 500-550 cc implants, I was hesitant.... but now they feel to have bottomed out... when I lay down they are at my armpit, and even with a bra barely have top cleavage or fullness. My next PO visit is in November... Should I call with my concern or wait till PO. SHOULD I HAVE TO PAY TO REPAIR?? I'm very upeset and unhappy with this

Doctor Answers 10

Drooping of Breasts & Implants + Stretch Marks 5 Mo. Post Op. Very Unhappy, What Are My Options?Answer:

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Doctors cannot predict how much any given patients implants may settle and your first post op pics show that they certainly were NOT placed too low. They are big but that doesn’t seem to be what bothers you. So I think you are looking at surgery to correct the position and it would be very nice of your surgeon to do it for free but I would not expect him to pay other costs. Smaller implants would seem essential as well because moving a 550cc implant uphill is very tough!!

Phoenix Plastic Surgeon
4.7 out of 5 stars 48 reviews

Post operative dropping of implants

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unfortunately these changes can occur depending on size and weight of implants , and quality and age of skin and breast tissue.

this can occur despite the best efforts of your surgeon.  your early follow up photos look normal

options may be toward smaller implants and a lift.   its not unreasonable to charge fees as this is neither your fault nor the surgeons but your healing.


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

Bottoming out after breast augmentation surgery

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Dear Salvette,

I am so sorry this is happening to you, unfortunately, this is commonly seen in subglandular placement and/or large implants. The weight of implants will always stretch tissue and cause this type of problem with time. It is inevitable as gravity will always win. You could certainly benefit from a revision where the size of the implants is decreased, the implants are placed under the muscle for added support or if they are already submuscular, then a capsulorraphy. Best of luck, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Drooping breasts

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Your left breast doesn't look bad. The implant on the right is to far down and out. if you don't mind the size than just fix the right with just a tightening of the space (capsulorraphy). You can downsize if you are unhappy. You had some asymmetry pre-op. You should expect to pay the facility fees but not surgeon charges. You might need to pay for smaller implants unless your surgeon can speak to the implant rep about your case. Sometime the companies will work with the surgeon on this. Good luck.

Rapid Drooping of Breasts and Large Implants Plus Stretch Marks 5 Months Post Op. Very Unhappy, What Are My Options?

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TRULY sorry for the condition you find yourself in. But unfortunately it is the common result of using large breast implants, in a partially informed patient with unrealistic expectations. The choice of having Cosmetic Surgery and when doing so WHICH implants to have should be yours and ONLY yours. While others, including your surgeon can voice their opinions, you should make the last decision because ultimately you have the most to gain or lose based on this decision.

The female breast a sag assured appendage. You can count on a few hands the number of full breasted women in their 20's whose breasts still remain in exactly that perky position in their 50's and older. Gravity ALWAYS wins. By adding weight to this sag assured appendage - the breast, as we do when we enlarge the breasts, we INCREASE the speed of breast sagging by increasing gravitational pull on them. When you state that you are upset that 5 months after your augmentation you "barely have top cleavage or fullness", you obviously were not educated / informed that the top fullness of the augmented breast can be short-lived with large implants. Unless steps are taken to reduce the inferior slide (using smaller implants, using Strattice slings etc), the implants WILL descend inferiorly reducing upper pole fullness.

You need to have a cooperative discussion with your surgeon on how to best correct / improve this situation. This may require using smaller implants, correction of the inferior and side walls of the implant pockets with or without Strattice and maybe Breast Lift procedure.

Good Luck with your decision. Please, base it on facts not emotion.


Peter A. Aldea, MD
Memphis Plastic Surgeon

The look after breast implants is your decision

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Good communication is so important for good results, and the breast size and look should be your decision, not your friends, your mother, and not your surgeon. The surgeon can help guide you, though it seems you have very large implants which have stretched the skin, are poorly positioned, and have made you unhappy. Revision or outright removal may be a solution.

Best of luck,


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

Revision breast augmentation works.

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You do have some bottoming out, but the basic problems are that the implants are too big and too far out to the sides.

You can get major improvement with a revision, and you can do that after one more month.

Surgeons have different policies, and you should know your surgeon's policy.  We do not charge a surgical fee for revisions, but the patient pays for the accredited operating room and recovery room, for the new implants, and for the board certified anesthesiologist.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Unhappy about breast augmentation result

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You have included good photos, which help in understanding the result.  Large implants stretch overlying skin.  As the skin envelope expands to accommodate implants, the implants gravitationally settle to the bottom of the skin envelope, and because of the curvature of your ribs, settle out to the side as well.  This happens when mechanical devices such as breast implants are inserted into your body, and is NOT the fault of your surgeon.  In the early post surgical photo, your implants are front and center, well placed.

To diminish the "bottomed out" appearance, in my opinion, circumvertical reduction of the skin envelope (if you want to improve breast shape) may help.  Of course, over time, recurrent skin stretching may occur, reversing some of the correction achieved by tightening your skin envelope.


Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Breast Implant Malposition?

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Thank you for the question and pictures.  it is helpful that you have sent a series of pictures showing the progression of breast implant movement.

Unfortunately, it does appear that the breast implants have descended  quite a bit,  leaving very little fullness superiorly and nipple/areola complexes off centered on the breast mounds.  I would suggest continued follow-up with your plastic surgeon and calm communication expressing your questions and concerns regarding the implant positioning. It is likely, given the breast implants' position,  and your dissatisfaction, that revisionary surgery will be necessary.

In general, one of the most common complications after breast augmentation surgery is implant malposition. This occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (“riding high”), inferiorly (“bottoming out”), medially (“symmastia or uni-boob”) or laterally (falling outward into the axilla).

Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary folds..

I hope this helps.

Drooping of Breasts and Implants Plus Stretch Marks 5 Months Post Op. Very Unhappy, What Are My Options?

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Very hard to give accurate advise. if so unhappy than revision to smaller implant and a lift seems to be the only alternative, sorry. As for fees, I would not charge for my personal time but the costs of a new implant, facility fees and anesthesia fees are the issue. In my practice I would not charge those fees. 

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.