Is my BA bottoming out or laterally displaced? (Photos)

Question

Hi, I had 355cc motiva implants above the muscle in May 2025, I will attach a photo a few days post surgery. Am I bottoming out or are the implants laterally displaced? One implant sits a lot lower than the other, my nipples are not in line, and when I lie down they lie to the side near my armpit a lot. If I could get professional options please

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for over 30 years and revisionary breast surgery is a large portion of my practice. I rarely place implants on top of the muscle. The fascia of the pectoralis major muscle is thinner than tissue paper, therefore subfascial is the same as subglandular. You virtually have no support. Gala flex mesh or any other kind of mesh gives a very little support because the whole breast mound will move with the mesh included. Your best option is to go under the muscle and revise the lift. I have a whole gallery of patients with subglandualar augmentation that have "slid down". You should be able to have an excellent result. Best wishes to you.

Mert Demirel, MD · Answer

It is difficult to give a definite diagnosis from photos alone, but what you describe sounds more like implant malposition or pocket stretching than a simple normal asymmetry.
Bottoming out usually means the implant has descended too low on the chest, with too much fullness below the nipple and the nipple appearing relatively high on the breast mound. Lateral displacement means the implant moves too far toward the armpit, especially when lying down. In some patients, both can exist together, particularly with over-the-muscle implants if the pocket has become too wide or the lower fold has weakened.
A small amount of implant movement to the side when lying down can be normal, but if one breast sits clearly lower, the nipples are no longer aligned, and the implant falls significantly toward the armpit, it is worth being examined by your plastic surgeon. At this stage, if the pocket has stretched, massage or exercises usually do not correct it. The solution, if it is significant enough to bother you, is usually surgical pocket correction, such as tightening the lower or outer capsule and sometimes reinforcing the fold.
If your surgery was in May 2025, you are far enough out that the shape is likely relatively stable. I would recommend an in-person assessment with your surgeon or another board-certified plastic surgeon to determine whether this is true bottoming out, lateral displacement, or a combination of both.

Is my BA bottoming out or laterally displaced? (Photos)

Answers (2)

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