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.

Thank you for the question at pictures.

Precise advice  cannot be given without direct examination but I think you may be a good candidate for revisionary breast surgery;  I think you may be able to have  capsulorrhaphy performed ( permanent internal sutures to decrease the breast implant pocket space). For example, the capsulorrhaphy can be done to prevent the breast implants from moving laterally  (into the axillary area). This procedure is likely what your plastic surgeon was referring to as “tightening the pockets”.

You also have some asymmetry of the nipple/areola positioning;  this may be able to be improved upon with closing off the space of the left breast inferiorly.

Hopefully with these maneuvers,  breast lifting surgery will not be necessary.

I hope this helps.

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.