Is this normal for my breast to be this far apart when laying down? (Photo)

Thank you for your question. From your front view in a standing position, it appears as though you have a pleasing result. If you want to keep a natural appearing result, i would not recommend going larger. Not to mention the larger you go, the more stress you put on your tissues, and the increased chance you have of developing more displacement. If you did go a bit larger, I would recommend you not add a larger diameter implant, but increase the projection of the implant, although i don't think it will look as natural. In my opinion, 400cc would be way too large for your frame.  With regards to the lateral separation of the implants when supine... it is certainly not uncommon. In reality, any sizable breast without implants will fall to the side to varying degrees. How much an implant will fall to the side, will depend on many factors such as the shape of the rib cage, the size of the implants, the extent of the pocket made by the surgeon, your tissues and capsules thickness and integrity and ability to hold an implant well in position. Some tissues heal with laxity and thin capsules that do no hold an implant as secure as others. Some tissues and capsules have great integrity and heal at a more ideal thickness and consistency and are able to hold the implant in an ideal position. And then, on occasion,  there are those who heal with excessive thickness firmness and develop capsular contracture to have the opposite problem. Combine a narrow and oblique rib cage, and tissues that have a tendency to heal with laxity and thin capsules, the implant is sure to fall more lateral even if the surgeon creates a perfect pocket. There are many things the surgeon can control, and there are several unknowns and things a surgeon cannot control and has to use his knowledge, experience and best judgement to provide the best chance for a great outcome. The lateral displacement that you question, can be revised by lateral capsulorrhaphy ( lateral capsule repair ) which may or may not necessitate use of an acellular dermal matrix, such as Strattice, to reinforce the repair. These are all discussions you can have with your plastic surgeon. Best Wishes. Dr Sam Gershenbaum.

 I am sorry to hear about your concerns after breast augmentation surgery.
You demonstrate your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients.  This phenomenon is called lateral displacement of the breast implant;  it may be of concern from the visual and the discomfort standpoints. Surgical correction is an option.


Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline.   In my practice, I use a 2 layered suture technique (capsulorraphy) to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option (although not usually necessary) especially if significant implant rippling/palpability is present.


 Surgeon experience level and technical expertise play the biggest role when it comes to successful  outcomes with this type of revisionary breast surgery.   Careful attention to postoperative activity limitations as well as use of appropriate postoperative support of dressing/garments are also important. You may be able to  increase breast size further safely.  Care must be taken to avoid excessive tension upon the capsulorraphy repair I good morning and/or your own tissues anatomic restrictions.
 I hope this helps.

From your photographs, it seems like your breast implant position is quite normal with you laying on the back. Remember, if you're breasts were totally natural, they would probably have even more lateral droop. You should talk to your plastic surgeon about whether an increase in volume is prudent. You may expect even more sideways displacement when lying down if you have larger implants.