Revision Surgery to Correct Shifting Breast Implants?

What revision techniques are done to correct Breast Implants that tend to shift towards the arms, especially when laying down? Is the breast pocket resized to hold the breasts more in place? The implants are placed under the muscle and are 700cc saline.

Doctor Answers 15

Breast Implant Revision Surgey

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For implants that are falling off to the sides or into the armpits when lying down, you may need a capsulorrhaphy to tighten the pocket a bit.  This will keep the implants from falling too much laterally.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

I agree

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There are several ways to go about the operation. I would start with the capsulorrhaphy, where a small bit of capsule along the lateral aspect is removed to create a sticky area. The capsule is then tightened with sutures and the sticky areas also scar in to support the repair. I would keep the implants if there is no contraindication, and I would keep them in the submuscular position. I agree with a bra.

Correction for shifting breast implants can be done

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The simple answer to your question is yes, the outer implant pocket can be tightened through an operation known as capsulorraphy. This is often accompanied by release of other, complimentary portions of the pocket.

The situation you describe raises additional questions about complete release of the pectoralis muscle and about the relatively large size of the implants.

The most important factor in success is probably the choice of an experienced plastic surgeon.

Sutton Graham II, MD
Greenville Plastic Surgeon

Shifting breast implants may be difficult to correct with 700 cc implants

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I agree with the majoprity of answers here. With a 700 cc implant the weight tends to stretch the side of the pocket when you lie down. It is difficult to maintain that sized implant in the front of your chest by internal stiches due to the effect of gravity. That being said, if the implant pocket is severely extended along the side of your chest, then attempt at closing off the side of the pocket with internal stiches might be worthwhile.

When I do this I first remove the implant through the original incision. I then place 2 rows of internal permanent sutures along the side of the pocket to bring the skin side and the chest side of the pocket together. This narrows the pocket. In association with this you might consider going with a smaller sized implant to reduce the risk of recurrence. It may take up to 6 months before you know for sure that the repair has worked.

Robert B. Pollack, MD
San Diego Plastic Surgeon

700 cc is wide for breast implants

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700 ccs is a very large implant with a wide base. So, unless you are very wide chested, there is no way that you can keep your implants from pushing out to the side without placing a smaller implant. You would couple that with an internal stitching of the implant capsule (capsulorrhaphy) to hold the implants medially centered under your nipples. Good luck!

Treatment of shifting breast implants

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There are several issues here regarding management and treatment;

  1. These are larger than average implants, to minimize recurrence consider smaller implants.
  2. Unders tend to move laterally if the muscle is incompletely released. The implants could be moved to overs or you should stop performing pectoralis muscle contraction exercises.
  3. Textured implants are less likely to move.
  4. Given the size of these implants, use of supportive garment to minimize lateral displacement particularly at night are advised.
  5. Use of a lateral capsulorrhaphy to encourage medial displacement of the implants may be an option.

Of course an examination and review of your history could suggest other possible treatments. I hope this helps.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

The replacement with textured silicone gel implants would make a difference

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While smaller implants and a surgical closure of the implant pocket will hopefully correct the inferior and lateral displacement of your implants, the main problem is that you don't make sufficient scar tissue to hold the implants in the desired position. By replacing your breast implants with smaller textured silicone gel implants the breast tissue and the muscle tissue should attach to the implant and minimize the likely hood of the same problem happening again.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

Breast implant malpostion

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Considering reducing the size of your implants. The heavier the implant the more chance of malpostion of the implant as you own tissue can not support the implant. Once there is malosition the implant is removed and sutures are placed to help keep the implant in a medial postion.

Sharon Theresa McLaughlin MD
Long Island City Plastic Surgeon

Correcting sideways falling breast implants

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700 cc implants are very large. In my opinion, only a minority of women can have good long term results with such implants.

When implants are placed, a pocket is created for the implants. The pocket should ideally be centered under the nipple location and on the flat portion of the chest WITHOUT encroaching on the other side of the chest.

When breast implants "do battle" with a forward moving arm, EITHER the original pocket was made too large (for an over sized implant) OR the shape of the chest has a very limited flat plateau for the implants to sit on and the implants literally slip sideways with gravity. In many such cases, DELAYED pocket dissection takes place either bu itself o with breast massaging which increases the pockets leading to the "side slipping".

The BEST way to correct this issue is to fit you with breast implants that would conform to your chest. Putting in a large implant in a woman with a small beveled chest would produce your result and worse.

The way to do it is to narrow the side pockets surgically. This would work only if there is adequate scar tissue to stitch to and if the repair is not stressed by large implants constantly pushing against it. So - to get a lasting repair you may need to accept smaller implants.

Hope this helps.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Correcting implant mobility

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The are a couple of ways to approach an implant pocket that has stretched or was opened too much. The more common approach is to sew the pockets or capsule from inside to make it smaller. This is referred to as a capsulorrhaphy. Once this is performed you need to protect the repair by wearing a very supportive bra all of the time except when showereing for at least the first 6 weeks, possibly longer. Another approach is performing the capsulorrhaphy and supporting that repair with a material called acellular dermis (Alloderm/Strattice). Lastly, if your implants are partially under the muscle your plastic surgeon may suggest a neo-subpectoral pocket. This is a fancy term for trying to use your own tissues inside to support the new implant pocket. I would suggest meeting with a board-certified plastic surgeon so they can examine you and then review all of your options. Take care.

Dr Edwards

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.