Two year old implants - too wide and too low on my chest. How can I fix this? (Photos)

Question

I had an uplift and implants almost 2 years ago. They’ve not felt right since the beginning & surgeon agreed they aren’t as high as they should be. The ridge is also a real issue on my right breast. I had 240cc overs, moderate profile. I’m looking for advice on how to proceed - they feel too wide and too low on my chest wall - would snaller, higher profile fix this? Have they bottomed out? They've been painful since the day i had them in.

Daniel Barrett, MD · Answer

Dear Passionate180775,

I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mehmet Ozdemir, MD · Answer

I am truly sorry to see the discomfort and visible distress this has caused you, especially since you have been in pain since day one. Looking at your photos, it appears you are dealing with a combination of "bottoming out" and lateral malposition , where the implants have migrated too low and too far toward your armpits, which explains that wide, heavy feeling on your chest wall. The "ridge" you mentioned and the persistent pain could indicate that the implants are putting undue pressure on your sensory nerves or that the pockets were over-dissected. Switching to a smaller, higher-profile implant is actually a very smart instinct; a narrower base would keep the volume centered on your breast mound rather than spilling into the armpit. However, the most critical part of your revision will be a capsulorrhaphy &mdash;a surgical procedure to sew the internal pockets tighter and "reset" the bottom crease (IMF) higher&mdash;to provide the structural support your current tissue is lacking. Given the chronic pain, I would also recommend a thorough evaluation to ensure there isn't any underlying capsular contracture or nerve entrapment contributing to your symptoms.

Robert M. Lowen, MD · Answer

Dear Passionate, this is the common problem of over dissection of the pocket, and inferior and lateral displacement as a result.  Beyond that, it is a problem of lack of soft tissue thickness to cover the implant, causing visibility of the implant in the upper pole of the breast.
   In order for the implants to be in an aesthetically pleasing position, and not sliding off the chest wall, pocket reconstruction is needed.  You probably had specific reasons for wanting your implants above the muscle in the first place, but the skin has stretched and will stretch back if pocket tissue is used to tighten and support the implant.   The current stretched dimensions show a much too long distance from nipple to inframammary  fold distance.  This needs to be shortened during a revision mastopexy and some reliable way of internally holding the implant on the chest wall must done.  
   Since you are over the muscle, you have the option of a new pocket in the neosubpectoral position, reinforced by mesh, that  should be considered.  Getting additional coverage of the implant by trying to get some of the pectorals over it would be good if it could be done, but often the pectorals retracts so far when their is an existing subglandular pocket  this is not achieved.  
   The shape of the breast can be dramatically improved when the footprint of the implant on the chest wall is correct.

Gary M. Horndeski, MD · Answer

At this time, I recommend explantation and lift using the Bellesoma. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Frank Agullo, MD · Answer

Two years post lift with implants and they sit too wide and too low. That is a pocket problem, not an implant problem. The pocket got over dissected at primary, the implant settled there, and the soft tissue couldn't hold it back. Honest answer: time isn't fixing this. Had a patient last year with almost the same setup. The repair was a capsulorrhaphy (suturing the loose lateral and inferior pocket closed) plus an internal scaffold of GalaFlex Lite to reinforce both the inframammary fold and the lateral border. Sometimes a smaller or narrower implant goes back in if the original was too wide for your chest to begin with. Bring your op report and current photos to a surgeon who does revision aug work in volume. This corner of breast surgery is finicky and technique matters a lot.

#StayBeautiful,

@RealDrWorldWide

#StayBeautiful,

@RealDrWorldWide

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. It is difficult to assess from the photos only. Revision should be able to provide satisfactory improvement. IT is very important to discuss all this with your surgeon. 
I wish you the best.
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Two year old implants - too wide and too low on my chest. How can I fix this? (Photos)

Answers (6)

More Breast Implant Revision Questions

Is it worth exchanging silicone for Motiva ergonomix to improve rippling?

1 year post op - Bottoming out, implants far apart and cleavage gone. What implants would be best for a revision? (Photos)

What is wrong with my implants and what can I do to make them better?

Reconstructing the capsule - is this too complicated?

Implant revision - Would 350cc reduce the risk of bottoming out?

Can someone explain what has happened to create this divot in my breast and if it is fixable? (Photo)

WE SEND PRETTY
EMAILS