3mo post mastopexy & implant exchange- lots up and out movement with activities and fall to side supine. (photos)

Changed from saline over muscle to silicone ultra high under- same cup size. Originally A cup. With even slight exertion- cooking, cutting food, carry laundry, push grocery cart they move up and out- visible through a shirt and very annoying to me. They also seem to be wide- an underwrite bra makes the sides sore. What are my best options? I am thinking capsulorrhapy. Would alloderm be helpful? I am only 43 with active young children and I want to be able to workout for fitness and health.

Doctor Answers 6

3 months postop

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Your problem seems complex to analyze with just pictures.  At 3 months you may still have some changes to occur, and I would revisit your surgeon to discuss your options in the next 2-3 months.  If they fall laterally when you are laying down (or with gravity), that may be a capsulorraphy.  If they move with usage of your arms, and flexing of your pectoralis muscles, that is a different issue.

It is best to discuss your options in person, especially when you are discussion a movement related issue.

Orlando Plastic Surgeon
5.0 out of 5 stars 19 reviews

3mo post mastopexy & implant exchange- lots up and out movement with activities and fall to side supine.

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You need fat grafts and releases of tissue stuck to muscles... Best to seek a few in person opinions as to what options would achieve the best results... 

Breast implant and mastopexy, breast revision surgery

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Based on the views you provided, the breasts at rest have a nice shape and size and symmetry to them.
I understand the situation you are describing.  Under the muscle implants for active women may be a problem as you describe unfortunately.  The lateral fall out when lying down etc has to do with a wide pocket generally speaking.  In such cases, the usual approaches are to do capsulorraphy, a neopocket that is more medial and really limit lateral dissection, do a capsulectomy and make the pocket smaller and in some cases also use alloderm.  Such decisions can only be made with a proper consultation.  You may also need to downsize the implant in some cases.
Usually working out is fine, but I generally recommend that most patients who have had breast surgery, especially submuscular augmentation, avoid any chest exercises that activate the pectoralis (chest) muscles.  I try and explain to them that there really is no need to work those muscles as it doesn't really serve any measurable purpose.  You can certainly work out the rest of your body etc.  
The pain with the underwire bra, may imporve with time.

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Breast Lift with Implants

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Hi TinaBeans,
I am sorry you are having some issues.  Hard to say without seeing you moving, but it sounds like you have an "animation" issue with the implant under the muscle.  You look great to my eye lying down, and not too far out to the sides, but would be best to compare to preop.  I do not see a dent on the insides of your breasts lying down, so that is good, also.  From the side you have some irregularities, but give it all a few more months for that. Some surgeons swear by Alloderm or the like, and others say they never use it, and it is unnecessary.   I would return to your surgeon and talk all this through.  Then come up with a future plan, and no harm in seeking other opinions.  I wish you all the best, "Dr. Joe"

Breast Implant motion 3 months after breast lift with augmentation

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You are still very early after recovery and at rest your result looks quite good.

However because your implants were placed under the muscle you are experiencing motion of the implant caused by muscle contraction when you place your hand on your hip.  As your breast implants drop further this may become less noticeable.  It is also not unusual that the breast implants are more widespread when the implants are placed beneath the chest muscle.

The visible depression or contour that you notice on the right breast may be the attachment between the chest muscle and the overlying breast tissue and skin.  If this persists fat injection might help.

Another option if these difficulties persist after a few more months might be placing AlloDerm beneath your breast over the pectoralis muscle if muscle adherence is the problem diagnosed by your plastic surgeon.

Please follow-up with your plastic surgeon and express your concerns.  For more information on combining breast augmentation with breast lift please read the following link:

Breast lift and augmentation

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I think that you have to give it more time for things to settle down. It is only 3 months since your surgery.  Be patient. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.