Left breast implant (subglandular) never dropped into place but feels soft and squishy - advice? (photos)

Question

My left implant is higher than my right. Most visible when I lift my arms; my left breast pulls up and makes a different shape. The fold of my left breast is directly on the incision, whereas the fold on my right breast has dropped lower. They put me on Singulair but I want other opinions before I start meds. I have 255cc implants, subglandular—both feel soft/squishy, but my left never dropped into position beneath the incision despite fluffing. Is this definitely a capsular scar issue?

Brian K. Reedy, MD · Answer

Thanks for your question! It looks as though you still have steri-strips on unless these are old photos. If they are newer photos, you are still early in the post-op period. However, capsular contracture tends to happen more in subglandular augments. I would follow your surgeon's instructions. Good luck!

George Bitar, MD · Answer

There are a few reasons if the implants are in different positions after surgery.  The most common is that you are still recovering.  Based on your photographs, it is difficult to tell how far out from surgery you are.  It may take 3-6 months for implants to settle into their final positions.  If you are still early in your postoperative period, then I would give the implants more time to settle.  The implants may be in different positions because of pre-existing asymmetries, such as one breast fold may have been higher than the other.  It is difficult to tell if you had asymmetry based on the preoperative photo you provided.  Finally, it can be related to capsular contracture.  Be mindful that a capsule will always form around an implant.  The question is whether the capsule is a creating a problem, such as changing the position of the implant, making the breast feel hard, or causing pain.  It sounds like you are doing the correct things.  I would recommend continued follow-up with your surgeon.

Daniel Barrett, MD · Answer

Dear SourMJT,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
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

Actually, you left implant is good and your right implant have dropped some. It would be best to raise the right instead of trying to lower the left. External ultrasound can be added to Singular to help loosen the left.

Cassie Nghiem, MD · Answer

Hi SourMJT, excellent question. It's not possible to answer that question without more history or an exam. Since the pictures still have the surgical tape, you're probably early in the healing process. Singulair is a preventative medication for capsular contracture, but it's not possible to say if you have it or not at this point based on pictures. I would be inclined to trust your surgeon who's had the chance to examine you.

Shana Kalaria, MD · Answer

It depends on how far out you are. If early, I would wait until 3-4 months postop before getting concerned about asymmetry. That being said, Singulair might be a good option to prevent a capsule from forming. You should be evaluated in person by your plastic surgeon or another board-certified plastic surgeon prior to that. Good luck!

Douglas J. Raskin, MD (retired) · Answer

Greetings: 
I think that you would benefit from a return visit with your surgeon to discuss your concerns. Your soft breasts with asymmetry may benefit from surgical revision or non-surgical care depending upon your re-examination.  The post operative photos do not reveal whether you were uneven before your surgery.
Your pre-surgical photo suggests that the left breast could have started out higher.
Best Regards,

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note that your left breast implant sits higher on the chest wall than the right, and the left nipple areolar complex "points" downward at rest, strongly suggesting constricting scar literally displacing the implant upward. A leukotriene inhibitor such as Singulair may possibly be of benefit, with little, if any, downside. Downward breast massage may be of benefit as well. 
If there is no improvement over time, a breast pocket adjustment may be required. 15% of cosmetic surgeries benefit from secondary touch-up procedures.
Continue follow up care with your plastic surgeon.
Best wishes...

Left breast implant (subglandular) never dropped into place but feels soft and squishy - advice? (photos)

Answers (8)

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