In which order should I have procedures done to enhance previous breast implant results? (photos)

Question

I had two 380cc high profile under muscle implants done last year I had an infection after surgery in the one breast, ever since I’ve had a noticeable difference in my breasts. When I lie down one falls into my armpit and they just sit very far apart on my chest. I’ve been offered to change them from under to over muscle and it may help however have been advised I’ll likely need an uplift in the larger lower one in the future. I’m unsure what surgery to have first?

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. Based on your photos, you may benefit from having an uplift procedure at the same time as your implant exchange. Changing the plane for the implant from under the muscle to over the muscle should improve your cleavage (but does have some disadvantages such as an increased risk of implant rippling) by enabling the implant to sit more medially. Tightening the skin envelope at the same time with an uplift will help to support your new implants and enable the nipple position relative to the implant to be optimised.

Steven H. Wiener, MD · Answer

Thank you for your question and photos. After reviewing your photos, I don't think you need a mastopexy or lift.  Your problem is common, your implants have moved laterally, falling into your armpits.  This is common with sub-muscular implants, contraction of your pectoralis muscle pushes you implants laterally, giving you a very wide space between your breasts.  Options to correct this include tightening the lateral aspect of your implant pocket or changing your implant pocket to on top of the muscle.  You don't need new implants, as yours are only one year old, only you want to change size.

Daniel Barrett, MD · Answer

Dear Bright515226,
you can get it all done in one session. If the main issue is implant movement, then implant pocket should be improved in order to keep the implant in place. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I encourage you to visit with a few board certified plastic surgeons to listen to varying opinions.  If one breast is larger than the other you can consider two differently sized implants to improve asymmetry.  If one falls to the side you can consider having the capsule tightened to keep the implant more central.  There are benefits and drawbacks to each placement (over vs under the muscle) which also should be discussed before you decide on a surgical plan.

Connie Hiers, MD, FACS · Answer

The side that has the higher nipple shows that your implants is bottoming out some. Once this is corrected, your nipples may be at the same location.

In which order should I have procedures done to enhance previous breast implant results? (photos)

Answers (6)