Breast Implants Move to the Side when Lying Down

Implants are held in position by the scar capsule that naturally forms around anything palced in the body. Larger implants will tend to stretch the scar pocket as it forms and one manifestation of that is when the implants slide laterally. Another one is bottoming out. Although sometimes repairing the capsule with internal stitches is successful, often the capsule needs reinforcement. Strattice is a very good option for that - info here: www.renewingyou.com.

One of the most common concerns following breast augmentation is capsular contracture and hardening of the implants. Every once in a while the opposite problem occurs and the capsule is too loose allowing the implants to slide to the sides when lying down. Occasionally the use of a textured implants lowers this tendency but the trade off is a higher rupture rate. Alternatively a capsulorrhapy may help in combination  with nightly wearing of an underwire bra to hold the implants in place.

This is a common problem that internal sutures can improve (capsulorrhaphy).  These internal sutures assist in centering the breast implants when standing and especially when lying down.  The use of permanent sutures are placed in the capsule to basically make a new pocket for better placement of the breast implants.  Post operative care is very important for this procedure as you need keep your elbows by your side and limit lifting for at least 3 months.   If you start activity too soon, this could cause the repair to be damaged and your implants will return to their original position.  Find someone who has experience with capsulorrhaphy and can show you many examples of his / her work. 

Someimes the pocket expands around the implant causing the implants to slide just as you wrote into the armpits or off to the side of the chest.

Sometimes the pocket around the implant, the capsule stretches out and the implant moves too much.  This allows the implant to fall under the armpit almost and is very uncomfortable to sleep or to go without a bra.  Many patients are embarassed to go to the beach because they are flat with all the implant out the side when they lie down.

The treatment is to repair the capsule called a capsulorraphy.  This will close off the lateral portion of the pocket so the breast doesn't fall to the side.  This is very similar to the correction for bottoming out.  Discuss the problem with your surgeon to see just how lateral this is and whether he/she would wait to see if the pocket has stabilized or you are ready for a revision.  Good luck.

There are a number of factors to consider. The first thing I would say is to ask your plastic surgeon what they think and if something needs to or can be done. If the pocket that heals around the implant, called the capsule, is too large or lax in any dimension, the implant can move there. If there is a need to repair or fix this, your plastic surgeon can go over those options with you.

I wish you well.

Dr Edwards