Do I Need a Revision (1 Yr After Ba)? (photo)

I had a breast augementation about a year ago. I went 4 sizes up: 350 moderate plus saline overfilled to 365 left and 375 right. When I stand up my breasts look ok but when I lie down the left one fall all the way to the side almost to the armpit and up to my collar bone, while the right one is perky and it kind of looks like if implant wasn't placed centrally. It really bothers me the way it looks. Should i get a revison? Thank you

Doctor Answers 5

Larger Pocket For Implant Requires Revision


Thank you for sharing your photos.

It seems that your left implant is sitting in a large pocket hence when you lay down the implant will tend to fill this gap on the lateral side of the left pocket.

An internal lift (capsulorrhaphy) closing the aforementioned gap hence resizing the pocket for a better fit of the implant will be the best approach.

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Orange County Plastic Surgeon
5.0 out of 5 stars 196 reviews

Breast Augmentation Revision after Saline Implants

Hi Ann,


Implant malposition is one of the most common problems after breast augmentation. Lateral displacement seems to occur most frequently with smooth, saline implants. In your case, the displacement is most likely because the implant pocket is too large on your left side. There are several ways to correct this. The most common would be capsulorrhaphy, where sutures are placed internally to make the implant pocket smaller. This works well, but sometimes the repair can fail because the tissues are thin. I do a lot of breast revisionary surgery in Austin, Texas and I like to use Strattice to reinforce my repair. Strattice is a biologic tissue matrix that reinforces tissue and helps to hold the breast pocket and the implants in the desired location. I use it in cases of lateral displacement, medial displacement or symmastia and for correction of bottoming out. It does add cost to the surgery but minimizes the risk of your own tissues failing and the need for a third operation. You should speak to your surgeon about your concerns and discuss your options. You may also wish to seek a second opinion. If you do decide to undergo revisionary breast surgery, please be sure to choose a surgeon with a lot of experience in this area. These cases can be challenging. You may also check out the website below for more information on Strattice in the treatment of malposition. Good luck!


Ashley Gordon, MD, FACS

Board-Certified Female Plastic Surgeon

Restora Austin Plastic Surgery Centre


Ashley Gordon, MD
Austin Plastic Surgeon
4.9 out of 5 stars 36 reviews

Revision after breast augmentation

You have a superior and lateral implant displacement on the left side when you lie down. This is most likely due to implant pocket is created to big in relation to you implant and to your right side. The issue is whether or not this should be corrected with a revision surgery. If you are bother by it significantly then at least you should find out what are your options. You also need to find out what are the risks associated with such revision. Most likely you will need to have the pocket on the left side adjusted to fit the implant better, especially tucking in from superior and lateral aspects. While this procedure is quite safe but it's not without possible risks and complications. Because it's elective, weigh the pros and cons before deciding.  Go back to your plastic surgeon and express your concerns. If you are unsure then seek 2nd opinion. You need to find a plastic surgeon who will clearly discuss and define and benefits and limitations of the revision surgery.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews


A revision is only necessary if it bothers you.  It sounds like the pocket is too wide and that is why you are getting lateral displacement. A capsulorrhaphy ( tightening of the capsule) might help.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Revison of breast implants?

Dear Ann.  Aesthetically, your breasts look fine when standing up.  It's clear you're getting a supero-lateral drift when laying down, but is that really a good reason to undego more surgery?  My opinion would be to wait.  Surgery involves risks and benefits.  Right now, you have a relatively high risk for a very small benefit.  As doctors, we're trained to imagine the worse case scenario.  In your case, if you had a re-operation and an implant got infected, then there's a high chance you would have to have your implants removed for 3 months to clear the infection before having them replaced.  For that reason alone, I would recommend you not have revision surgery at this time.  Hope this helps.

Victor Ferrari, MD, FACS
Charlotte Plastic Surgeon
5.0 out of 5 stars 36 reviews

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.