Revision for under-dissected pocket or muscle wasn't released enough? (Photos)

I think the issue may be the dimensions of the implant pocket relative to the dimensions of the implant itself. It appears that the implant may have elongated itself along the vertical length of your chest wall, rather than settling into the pocket that was created for it. A revisionary procedure using a smaller implant and some pocket modifications would be a straightforward solution to your issue.

Although a physical exam and a complete review of your history is needed, your implants are high, and too large for your dimension. They are most likely the wrong profile as well. Your initial presentation made you prone to this as you lack some lower and lateral (outside) pole tissue. I strongly suggest a revision and revisiting using smaller dimensional implants than the one that you have. A simple release of these will not likely correct the issue. Good luck.

Thank you for you question and pics: I agree that your implants are high, especially for 3mo post. They may "settle" (the lower pole tissue stretches to accommodate the implant ) but unlikely enough for enough for an implant that size and with your breast footprint. Unfortunately, we don't have a lateral pre-op view, but I suspect it would show a very tight lower pole/IMF (almost 90' angle). For the best result, I would wait 6mo to allow for maximal skin and capsule stabilization, more aggressive release of the muscle and likely downsize implant vs. anatomic implant.

Your issue may not be as simple as pockets not dissected enough or muscle inadequately released. The lower part of the breast just doesn't have enough room for the diameter of the implants you have. If the implants drop, you are at high risk for a double bubble. Further release of the muscle can contribute to animation deformity so that may not be the answer either. I would consider an oval base form-stable implant and possibly converting to the split muscle plane.

Usually by three months post-op your breasts implants have pretty much settled into place.However, it can sometimes take another few months to see your final results. Without having performed the operation myself, it's difficult to say whether or not the pocket was under-dissected.By looking at your pre-op photo, and looking at the apparent size of your breast implants, it is quite likely that I would have had to lower your infra-mammary fold in order to accommodate these implants. Without lowering the infra-mammary fold, the implants could end up too high, and would not be centered behind the nipple.You'd have to ask your plastic surgeon to find out what he/she thinks is going on. Definitely, wait a few more months before considering a revision.  The implants may settle into place more, and you could be happy with the results. Thanks for sharing!

strapping can still help.  If you have textured anatomic implants, I would be more concerned that you will need a revision if you want more natural looking breasts.  My main goal with my patients is to have a level upper pole and yours appear close to level, albeit excessive.  Lower folds and nipples may never be equal with each other due to what you started with.  So if smooth round, keep pushing hard and often... and if not, then you should be discussing your options with your surgeon.

At three months post-op the pocket has usually stabilized, and further descent of the implants is unlikely. When the implants are positioned too high, the nipple-areola position is driven lower. With a revision of the implant pocket called a capsulotomy, the implants can be repositioned for a more optimal shape. I would discuss the timing of this procedure with your plastic surgeon.

Although I do understand your concerns,  I am one of those plastic surgeons who would advise you to continue to be patient. I have seen breast implants continue to "settle" for the first six months after surgery and longer.  Of course, your plastic surgeon knowing exactly how/where the breast implants pockets were dissected will be your best resource when it comes to more specific  advise and/or predictions. If, in the longer term, breast implants are not where you wish them to be, capsulotomy (release of the lower breast pole tissues) will be necessary to achieve an outcome that you will be happier with.Best wishes.

This look is seen for two reasons, first is an incomplete release of the lower muscle because  the dual plane technique wasn't done, second, the implant dimensions are too big for your chest. But without access to the operative report and an exam of you, there is no way to know if this is correct. Any further changes in your contour after three months will be quite minor. 

I can see your concern from your photographs. The right breast started out with a higher crease and a smaller base width. It should take more time, all things being equal, for the right breast to stretch out that smaller skin envelope compared to the left. If, on dynamic flexion of the pectoralis, there is more muscle action on the right than on the opposite side, I believe that at three months, plenty of time has passed and without added release of this muscle, the implant will probably not drop any further. Your plastic surgeon will be your best resource to evaluate the situation. Best of luck.