Pockets Made Too Big Implants Move Around & Hang too Low, Can This Be Corrected Without an Uplift? (photo)

Hi there-

You didn't mention, but it looks to me like your implants are on top of your muscle. The problems you are having with their appearance are characteristic and incredibly common for implants placed in this position.

The fact that they often look good right after surgery (although I realize you have never been happy), there is less pain than with subpectoral placement, and many surgeons and patients view it as a way of avoiding a breast lift make it seem like an attractive alternative... but I have found that most often, when patients like yourself present to my office, they either don't remember being told, or just weren't told, that over time the implant appearance (and therefore the breasts' appearance) would suffer for the fact that skin and breast tissue don't hold up as well against gravity as the chest muscle does.

In other words, it looks a little to me like you are now paying the price for the short cut you tried to take in the decision making at the time of your first procedure... This will only be complicated by trying to take more short cuts to your desired appearance.

If your goal is to achieve a long lasting, beautiful, round but natural breast shape, your best bet (in my opinion) is to realize that you probably needed a breast lift in the first place 3 years ago- have these implants removed, replaced with smaller ones under your muscle, and have an artfully performed breast lift.

Of course, your choices are yours to make, but please realize that the most unhappy people I see are those who look for short cuts and cheap prices.

Correcting your implant problem means revising the breast pocket that the implants are in. Correcting the breast pocket may involve moving the implant into a new position under the muscle and then possible adding in a biologic dermal matrix such as Strattice or Surgimend to help support the implant in its new position. The dermal matrix will act like an internal bra. Once the implant has been repositioned then the breast, nipple position, and shape can be re-evaluated. You may require a breast lift if the nipple complex is to low. Sometimes I will opt to forego the breast lift if a patient is really worried about scarring. Let the breasts settle down for 3-6 months and if my patient is unhappy with the look of the breasts, I will perform the breast lift.

You have implant malposition. The implants have bottomed out. There are several reasons for this but weakness of the support system of the inframammary crease or violation of the crease during surgery can be one of the causes. This can be corrected in one operation by removing your implants and using a biologic mesh like SERI to support the implant and prevent a recurrence. May also need a breast lift to reposition the breast. 

It is possible that you would benefit from tightening of the implant pockets.  If they are already too big, I would not recommend fat injections which will create an even larger appearance.

If you decide to go smaller, you may need a lift. It is hard to say without an exam.  The pocket may need to be tightened as well.