i put silicone implants 690 cc completely under the muscle 2 years ago..

After two years, it appears that you may have developed caspular contracture if your breasts are firmer now.  They will most likely not soften up on their own.  You probably need to undergo a breast revision by an experienced breast revision plastic surgeon.  You may need to remove the scar tissue, change implants to something wider, lift the breasts, etc.  Revision breast augementation is not an easy thing, so investigate your surgeon and make sure he/she does alot of revisions.  I hope this helps.

Your breast implants have settled into this position and will not change any further since your surgery was done two years ago. Based on the photos I would not recommend any additional surgery to attempt to create cleavage either. A board certified plastic surgeon can evaluate you in person and give you more specific answers to your questions.

Best wishes,

Dr.Bruno

Your cleavage is wide because implants are submuscular.  Since muscles on two sides are seperated by your breast bone the cleavage also is wide.  Nothing can be done. 

At two years post-op breast augmentation surgery, it is unlikely that your results will change further. Consult with a board certified plastic surgeon to discuss revisionary surgery if you are wishing to change the look.  Remember that revisionary surgery is tricky and no result is perfect.  
Clear communication with your plastic surgeon is important in achieving the desired goals of the patient.  I like to communicate with patients with “goal” pictures.  During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for.  When I have the patient in the operating room, i adjust the size and pocket to try to get the patient's desired look.  Not all surgeon's perform revisionary breast surgery so do your research and find one that you connect with and like the results you see.

It is unlikely that breast implants will fall after several years, unfortunately.  There may be other options that are more surgically active that you will have to consider, and your Plastic Surgeon should be able to discuss these choices with you.  Open capsulectomy for the removal of the capsules, downsizing of the implants bilaterally,placing implants into a new pocket above the pectoral muscle, all of these options may have to be considered.Good luck to you.Frank Rieger M.D.  Tampa Plastic Surgeon

Hi goodfornothing,

At 2 years, it's unlikely they will move much on their own.

Of course, it's very difficult to say anything specifically without being able to see you in person, and you should, of course, talk to a board-certified PS about all of this.  Based on your photos, though, I would say that (1) the implants are a little high (probably because you had a bit of sagging beforehand - nothing personal, of course - and either didn't want to do anything about it or the decision was made not to do something at that time), (2) the implants are a little far apart because your skin is very tight centrally.  I would certainly advise you NOT to try to put them closer together - that can lead to all sorts of potential problems, and particularly so in patients with thin skin (like you).

That being said, you could discuss lowering your implants.  Talk to your PS and see if this is worth it.  You have a generally very nice result with implants that are a bit high - but a secondary procedure, if the overall result of the first is good - is not something to be taken lightly, as there are risks involved.  You have to consider whether the anticipated benefits of a relatively small adjustment (depending on how you look at it, of course) are worth going through another surgical procedure with its attendant risks.

Again, no right answers - but well worth discussing with your PS.

I hope that this helps, and good luck,

Dr. E