Why can’t you achieve upper pole projection with breast implants?

Question

I am 41 years old and had a breast augmentation 2 years ago which bottomed out in 6 months. I recently just had them redone, it’s been a month and they already dropped to the point it looks like I have no implants. I have no upper pole projection. :( I’m so upset over this and I’m wondering if maybe I would never be able to achieve that.

Daniel Barrett, MD · Answer

Dear LiliDiaz,
upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to revision breast surgery.  One of the most common causes for recurrent bottoming out is implants that are placed on top of the muscle-subglandular position or using too large of an implant in lieu of performing a breast lift.  Either way, you should be able to achieve upper pole fullness by the placing the implants under the muscle, performing an internal bra procedure-capsulorrhaphy, and/or breast lift-mastopexy.  Best wishes to you.

Robert M. Wald, Jr., MD · Answer

Breast implants provide weight to the breasts and over time, especially if the skin is elastic and very stretchable, the implants will drop. Textured implants adhere to the chest wall and can maintain upper pole fullness better. Sometimes. a tissue matrix (Statice), is needed to support the implant. I would talk to your surgeon about these options.

Connie Hiers, MD, FACS · Answer

If you are selecting large heavy implants, they will not stay up high from thinning and stretching your own tissue. Since you bottomed out twice, I suspect your implants are too heavy for your tissue. You can also add a fat transfer to help give more upper breast fullness if you have donor fat.

Why can’t you achieve upper pole projection with breast implants?

Answers (4)

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