Can this cleavage issue be fixed? (photos)

425 cc over muscle mentor high profiles, placed 2 years ago. Noticing my cleavage appears saggy on left side, almost a pulled webbed skin look in the lower left cleavage. (Right in photo) is this fixable w minor tweak or will I need a revision ? Is it bad enough to warrant one? Also what do you think of the work my doc did? I do have much firmer breasts than when I 1st got them, too.Thank you

Doctor Answers 10

Wrong implants choice

It seems to be very clear your implants were not chosen based on antropometric dimensions (as all should) but upon mass / volume parametres therefore leading to protrudring and oversized base widths of the prosthesis.

Not only that, the pocket for the implants is insufficient and at this moment the prostheses are "intraglandular", which means fully wrapped within breast tissue above the dome of the implant (the rule) and weirdly underneath them too behind the base, with no adhesion or contact between implant and ribcage; this makes the implant a gravitational burden on your breast pouch which is pulling down creating a droopiness of iatrogenic effect, one sign of this is the webbed skin.

You need full revision, the sooner the better to avoid the unstoppable progression of your droopiness (in the near future you might be a case for mastopexy and require massive scars to fix your issue), using latest generation anatomical shaped implants, cohesive gel filled and macrotextured, of a better chosen base width, and eventually a capsulorraphy at the bottom and sides to bring the skin back to the chest and redefine the new breast pocket.

Not only a minor tweak is unsuitable for you, I must tell you that fixing your problem with harmony and brilliant results is one of the most difficult procedures in revision surgery of the breast, and few surgeons master this technique. Do research well experience. Do not accept a breast lift, which will be the suggested solution by 90% of surgeons you consult with, go ONLY for the before mentioned plan: new implants made to fit your cage and capsulorraphy to get rid of the excess of breast pouch created by the gravitational pull of the implants.

Note: you don't suffer bottoming out, since bottoming out is when the implants slide downwards to the tummy through a channel made underneath the ligamenst of the submammary fold (normally due to poor adhesion of implants when they are smooth or microtextured, or when the patient misbehaves or is not instructed to keep 4 weeks of absolute immobility in the postop); your implants are not sliding underneath the submammary fold but above it, the submammary fold ligaments are totally competent in your case and your prosthesis "falls" down the "cliff" pulling down the breast (in bottoming out the breast is not pulled down or affected, to the contrary, remains strictly in place since it si the implant moving down dissociated from the breast.


Spain Plastic Surgeon
5.0 out of 5 stars 34 reviews

Breast Revision?

It appears that you have developed capsular contracture around the implants, causing them to look more constricted and pulling away from the midline.  I recommend changing position of the implants to a subpectoral position.  This would create a new pocket for the implants to sit in a different position, as well as stabilize the implants from falling to the sides as much as they probably do now.  The rates of getting recurrent capsular contracture are also lower underneath the muscle.  I hope this helps.

Can this cleavage issue be fixed?

Thank you for the question and pictures. Based on your concerns, it is likely that you will benefit from revisionary breast surgery that will include additional support of the breast implant capsules (capsulorraphy) plus/minus the use of acellular dermal matrix or biosynthetic mesh.  The attached link may be helpful to you as you learn more. Best wishes.

Breast asymmetry after Breast Augmentation

An examination of your photos would suggest that you have lost lateral support of your left breast implant. The best way to determine if this has occurred is to lie down and observe the difference in the way your breast implants move. I would suspect that your left breast implant will fall to the side to a greater degree than your right breast implant, indicating a loss of support of the implant by the internal ligaments of the breast. The loss of this support does require a revision surgery, but the good news is that the surgery is usually very successful. Please speak with your Plastic Surgeon to discuss your concerns and make a plan to address them.

Douglas Leppink, MD
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 23 reviews

Breast implants - cleavage is changing. Can it be fixed?

Thank you for asking about your breast implants.
  • If you are happy with the implants, I would leave things alone until you want something done.
  • You appear to have large implants -
  • Like naturally large breasts, their weight pulls them down over time.
  • I think your doctor did a good job - if the extra-large implants were your choice.
  • If your implants are much firmer, you may have a capsular contracture, contributing to the cleavage pull lines.
  • If you decide to have something done, it will include smaller implants and a revision of the pocket (capsulorrhapy), possibly a lift and internal support with material such as Vicryl mesh or ADM - so it will not be a minor tweak.
  • Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Revision Breast Surgery

This is likely a result of the implants being above the muscle.  If you were interested in a revision, I would recommend placing the implants under the muscle, and using a smaller implant.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a board-certified Plastic Surgeon certified by the American Board of Plastic Surgery. Best wishes! Dr. Desai
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Your breasts

What you have are very large iimplants -- and I hate to disagree with my colleagues, but it is irrelevant as to if they are over or under the muscle as they both sag. Muscle NEVER covers the inferior half to third of the implant , so the larger they are the more they sag. Bras help -- but smaller implants might be better. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.1 out of 5 stars 11 reviews

Large implants placed over the muscle do not age well

Dear mn1979,
You are beginning to show the longer term effects of placing large breast implants above the muscle.  Since there is very little tissue to support the implants in this position, they commonly sag over a relatively short period of time (a few years) and create the "rock in a sock" appearance.  You may be able to stave it off for a while with around the clock support bra use, but the webbing that you describe is likely to continue to worsen over time.  Correction could involve a complicated surgery including repositioning the implants to an under muscle plane and a breast lift.  Good luck!

Augment revision

implants placed over the muscle have much greater odds of producing sagging. Your implant profile is too wide for your chest. Also keep in mind that breasts are not perfectly symmetrical.

Cleavage

Seeing preop photos would be helpful and other views. It looks like in the photos that you might need a lift to raise the breasts a bit. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 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.