My Breasts Sag and Implants Flip Onto Sides? (photo)

I went from a 34B to a 34DD. My doctor said there was no sagging before and my implants would be saline under the muscle. After only 6 months they had already began to sag very low and the implants started flipping onto their sides. My doctor said it was nothing to worry about but they look nothing like they were suppose to and they are causing me extreme pain. I've just passed my 3 year mark and no one can tell they are even fake. Is any of this normal and if not, should he fix all of it?

Doctor Answers 12

Breast Implants

It appears from your 3 year post op photo that there is some ptosis (sagging) and asymmetry.  Your left breast may be developing a capsule and may be the reason for your discomfort.  Your right breast appears to have some volume loss and the sensation of "flipping" may be the saline moving from side to side in the implant.  To improve the appearance of the breasts and alleviate your symptoms, I would suggest capsulotomies, breast lift, and possible replacement of saline implants with silicone gel.

Albany Plastic Surgeon
5.0 out of 5 stars 4 reviews

Sagging breasts after augmentation

Thanks for your question.  Unfortunately, this can be a "normal" occurrence after breast augmentation surgery.  With very large implants, the skin stretches and over time the breast can "sag" over the implants.  The larger the implants, the more the skin has to stretch and patients can develop the situation you are faced with.  


As far as the implant "flipping", this can happen if the pocket the implant sits in is too large.  This can create some discomfort.  Solutions for these problems require surgery to lift the breast and modify the pocket that the implant sits in.  You should see your surgeon to discuss your options given your preferences for breast size and possible scars.  

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 36 reviews

My Breasts Are Saggy And Painful - What Can Be Done?

The implant that you feel flipped onto its side is either a capsular contracture or you have anatomic textured implants.  Round implants in a reasonable pocket cannot lie on their side.  Also, your original pre op pictures show arms up which makes it very difficult to evaluate position of nipples, and therefore degree pre op ptosis (droop). 

A complete evaluation including chart review would be necessary to aid any surgeon in giving you assistance in determining why your breast drooped and what can be done to correct them. 

Breast drooping over time is not unusual, especially with large implants.  There are so many variables, it is hard to say what is normal.  For instance, do you wear a bra or don't you; are you a marathon runner; your age; ethnicity; and number of pregnancies which may have intervened between the original surgery and the 3-year follow up. 

In my practice, for a period of 12 months, I will touch up any complication that occurs at no charge to the patient for the surgery or new implants, and they only pay anesthesia fees. 

Possible problems with overfilling of saline filled implants

It appears that you had a nice shape to your breast prior to surgery.  It appears that the excessive weight of your breast implants have created a clinically significant breast sagging.  If you wish to remain the same size you are now but want more youthful appearance to your breast then you may consider a breast lift.  If you had saline filled implants that were overfilled it is possible that the implants are rotating in the pocket.  The implants have a front and a back side.  If a saline implant is overfilled it becomes round and will rotate to an unnatural position.  Find out if your implant were overfilled and this may be your answer.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Breast sagging after breast augmentation

Thank you for your question.  There are many factors that will affect the appearance of your breasts after breast augmentation.  The most powerful factor is gravity.  When standing, the gravitational forces cause pressure on the skin of the lower pole of the breast.  When pressure is exerted on the skin for prolonged periods of time, the skin will grow which ultimately causes the breast to sag.  When lying on your back, the gravitational forces causes pressure on the skin of the lateral pole of the breast.  This ultimately causes the breast implant to slide off the anterior portion of the chest toward the lateral chest wall.  The best way to minimize the gravitational effect on the breast skin is to wear a supportive bra as much as possible including while sleeping.  The greater the size of the breast implants, the faster the skin stretching will occur.  


It is very common to see patients who have similar concerns after having breast augmentation with large breast implants.  My recommendation would be to have a discussion with your plastic surgeon regarding downsizing the breast implant and having a breast lift performed to reduce the amount of excess breast skin.  This will provide you with a higher fuller appearing breast even though the breast implant is smaller.  Keep in mind that the breasts will not be able to stay high and full forever because the gravitational pull on the breasts will not change.  If however, the breast pain is a factor than a discussion of implant removal alone or with a breast lift should be discussed.  I hope this helps.  Best wishes!

William J. Vinyard, MD, FACS
Palm Beach Plastic Surgeon
5.0 out of 5 stars 33 reviews

History & Physical Necessary

Thank you for your question. Unfortunately a thorough history and physical examination is necessary to appropriately address your concerns.

George Bitar, MD
Fairfax Plastic Surgeon
4.6 out of 5 stars 55 reviews

Late Changes after Augmentation

For some patients the breast and body can change over a short period of time.  Comparing your current photo to your preop photo shows an increase in native breast volume and a loss of support.  Additional pregnancy, weight changes, smoking, gravity and aging can all have a negative effect on the breast.  You may need to consider changing the size and/or type of implant.  In addition you may want to consider a breast lift.  Hope this helps.  Good Luck

Brian K. Reedy, MD
Reading Plastic Surgeon
4.9 out of 5 stars 145 reviews

Breast Implant Problems

Your pre-op picture show good breast volume.  Your post op show quite of bit of skin stretch. Your implants may be too large.  Solutions: (1) performing a lift over your existing implants; (2) downsizing implants and performing a lift; (3) removing your implant if they are painful and performing a lift immediately or at a later date if needed.

Dr. ES

Implants flippinf and sagging

You may need a revison to improve the sag with a lift and correct the pockets if the implants are too mobile in the pocket.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Implants Flipping and Lift

   If the implants are truly flipping the pockets can be revised.  If you would like the breasts to look higher, a breast lift would be necessary. 

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 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.