Will I require a revision surgery? (Photo)

I had a BA 3.5 years ago. I went 425cc HP saline implants under the muscle. My left breast has always set a little different than the right and I've never really been happy with my results, but recently I've noticed that my left breast now falls into my armpit and leaves a horrible indentation while I'm laying on my back. I'm very self concious when my husband is looking down at me. Im wondering why this would happen and if this requires a new surgery to fix. Will a larger implant help?

Doctor Answers 9

Reasons Some Seek Breast Revision Surgery

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The most common reason women seek breast implant #revisions are to change their implant #size, or, capsular contracture. Sometimes, both. Capsular Contracture occurs in about 5-10% of breast #augmentation patients. However, only a small number of these patients experience pain or visual issues that actually require correction.  Additional matters of concern which some patients #elect to have a revision are due to malposition of the implant, changes in shape and size following pregnancy, weight change and #deflation or #rupture of an #implant; to name a few. Please be advised that each patient is unique and previous results are not a guarantee for individual outcomes. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.

Will I require revision surgery?

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  • From your picture, it appears your implant has gone into your armpit on the left side. This is usually the result of an implant pocket that has stretched out. Some people’s tissues are just more stretchy and lax than others and that is the reason that can happen. Fixing this would require, what we call, a pocket revision that involves placing some sutures on the lateral aspect in the pocket to “in essence” close down that pocket so the implant cannot migrate to that area anymore. With a smaller pocket, therefore, the implant will sit in a more medial location and fill the gap on your chest when you lie down. I do not recommend choosing the larger implant to correct this problem. With extra weight, the implant will just put further stress on the tissues and could lead to further stretching of the pocket. 

Need for revision surgery is determined by the patient

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and no one else.  Yes, you are asymmetric and your left implant slides out farther than you desire.  Are you at the point where you are willing to accept the risks and costs of having a revision procedure that may not work?  If so, then see a local surgeon for further advice on how best to correct your problems.  And you should take in a list of things you wish to correct so they can all be addressed as some issues may not be fixable.  If you're not at that point yet, try not to worry about it and enjoy life as it is.  Your spouse should not be seeing what you see so don't let that be the reason to jump back into the OR.

Breast Augmentaion revision

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Hi and thanks for a great question.

I'm sorry to hear that you are having issues after a procedure.  It seems from what you stated and what I can make out from the photo that you have implant displacement issues.  The breast implant is drifting away from the midline (the center between your two breast). 

The capsule or pocket that was created during your orginal surgery, possibly needs to be repaiedr so the implant will be closer to the midline and the isue of the implant drifting (when you lay down, etc) is solved.

Don't worry, this isn't a totally uncommon problem, so take heart that it can easily be corrected.  Seeing a board certified plastic surgeon is the best way to ge the best answers.  So please, start there as you decide to move forward.

All the best,

Dr. Obeng

Will I require a revision surgery?

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I am sorry to hear about the problem you are experiencing after breast augmentation surgery. Based on your description and pictures, it seems like you are experiencing a breast implant displacement problem.
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. Doing so will prevent the breast implants from migrating to the sides when you lie down and will help centralize the position on the breast mounds. In my practice, this repair is done with a 2 layered suture technique. The use of acellular dermal matrix is an option ( although not usually necessary) especially if significant implant rippling/palpability is present.
There are a variety of options when it comes to selection of breast implant size/profile. In your case, careful preoperative communication regarding your breast size/shape goals will be important when it comes to making recommendations. I find the use of goal photographs very helpful during this process. The use of temporary intraoperative sizers will also help determine the best size/profile breast implant to utilize.
I hope this, and the attached link (dedicated to lateral breast implant displacement concerns) helps. Best wishes.

Will I require a revision surgery?

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It really requires a physical examination to determine what is going on and if larger implants will help. Based on your description, it sounds as if the pocket for the implant needs to be adjusted. I'm fairly certain that if you want your current situation to change, you will need some sort of revision surgery. I would recommend that you go back and see your original surgeon and see what he/she recommends. Best of luck!

Terry E. Restivo, DO
Napa Physician

Will I require a revision surgery?

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Thank your for your pictures and questions. I am sorry to hear that you are having problems. It is hard to tell what exactly is going on without and in person consultation and examination. But it sounds like from the description, you have some lateral displacement of the implant pocket on the left side. If this is severe enough and is causing you issues, then it may require revision surgery. See a consultation with the surgeon who performed your procedure or a local board certified plastic surgeon to discuss your options.

Best of luck!

Lateral implant displacement

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Thank you for the question and photo and you are not alone.  Your pocket has stretched laterally and would benefit from a revision.  So see some experts in your area.

Dr. Corbin

Implant malposition

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It is not unusual for implants to fall more to the side after a while.  Correcting this can be tricky and usually involves closing the capsule off from the inside.  It appears your situation is only mild malposition and probably not worth undergoing a complex revision.

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.