Can implants be placed closer together than natural breast? (photo)

Question

I had a breast lift and saline implants in 2016. I’m thinking of changing to silicone but I would like to know if they can be placed closer together then their natural position? Between a natural gap and the heavy sag with saline I am ready for a change.

Mark McRae, MD · Answer

Hi there,
Implant position can be changed and implants can be moved more towards the midline. Implant malposition is a common reason for implant revision surgery. Implants can migrate laterally over time. I see this more commonly in patients where implants are placed under the muscle. Implant position change to above the muscle (under the gland, or under the "fascia") can help as well as supporting the inferior lateral breast tissues to push your implants more medially. There are pros and cons to this though of course. Since this is a revision for you (secondary procedure) there is more work involved to achieve this position than after the initial placement of your implants (primary surgery).The implant size is limited and the movement in any direction is limited by your anatomy. Going too large and ignoring or damaging the natural supporting structures of your breast will lead to problems in the future that require more complex operations to fix. Make sure you consult with a board certified plastic surgeon so that they can assess you properly and advise you about what is advisable in your specific case.

Daniel Barrett, MD · Answer

Dear 40girl,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Your photo is not helpful except to show your implants are too large for your frame and tissue. The bases of your breasts cannot be moved, but the lateral pockets can be tightened so that the implants have a smaller space. Fat can be added to the inner breast to help give more volume there and decrease that space.

Mark Eberbach, MD · Answer

Unfortunately, your photographs does not reveal sufficiently to answer your question.  Very often implants that are older will move outside and down so that one loses the upper pole fullness.

A capsulorrhaphy with implant exchange, often to a smaller implant will significantly improve most patients circumstance.  Good luck.

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