1 year postop - Are my implants done wrong? (photos)

Good morning,
You have a little bottoming out, which typically causes the breast to sit lower, and takes away from your cleavage and upper pole fullness and is often accompanied by pain. When patients come to see me to have this fixed they say they often find themselves unconsciously holding up the affected side with their hand for comfort. I correct this with the Original Internal Bra, my strong permanent internal suturing technique, which will also improve your upper pole fullness and cleavage. I first developed this technique over 20 years ago, and today it is the most common revision procedure I perform, at least 5-6 times a week- it works and it lasts!

So your doctor should have told you whether your nipple position was symmetrical to start. Breast augmentation surgery does not affect your nipple position- augmentation surgery just enlarges what you have. Your inter-mammary distance has limits as to what implants can do. Fat grafting the contours medially can improve this gap but larger implants should only be used if you want a larger breast. Fat grafting can improve the upper pole fullness as can a larger implant. Motiva ergonomix?? Never heard of that... I would read more about that company and make sure they are legitimate. We use Allergan and Mentor. We are considering Sientra and have used Ideal implants. Definitely sit down with your plastic surgeon ( who I hope is board certified) and review your preoperative photos. Best Wishes!!

Dear Sammyjp1987,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went 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

Thank you for sharing! Differences in nipple position frequently exist before surgery. Many surgeons take measurements to determine nipple position before your operation. To obtain clarity, you can always ask your surgeon what your preoperative measurements were. Implants alone are rarely able to correct these differences and frequently make differences in nipple position more apparent. Usually, surgically changing nipple position with a lift is necessary to achieve vertical symmetry. For context, the degree of nipple position demonstrated in your photos is very common. Some patient's choose to have asymmetry like yours corrected, many do not because it requires additional scars.
The distance between your breasts is related to the technique of breast augmentation you had, the shape of your rib cage, and your tissue type. Dual plane breast augmentations place the upper aspect of the implant under the muscle. The sternal origin of the pectoralis muscle varies from person to person in terms of how medial the muscle attaches to the bone. The muscle origin must be protected so that it doesn't tear of the sternum (breast bone) and cause a window shade deformity. I always tell patients who are going to have a dual plane augmentation that I can only give them as much cleavage as the pec muscle will allow. Persons with a V-shaped chest wall (pectus carinatum) often experience lateralization of their implants. This is because the implants tend to fall to the side due to the contraction of the muscle and gravity. Persons with poor skin and/or tissue quality don't tend to support implants well which can lead to malposition. Your implant position appears to be within the normal range.
Breast pain after augmentation can occur because of muscle injury, nerve injury, rib irrigation or capsular contracture, implant rupture, excessively large implants among other causes. A detailed history and physical exam is necessary to determine the cause of pain.

You did not show your before photos, but the gap was probably wider before implants. You may have one nipple that sits lower and point out more than the other. Please look at your before photos. Please discuss any concerns you have with your doctor.

Before photos would be helpful in addressing some of your concerns. You may want to check with your surgeon about your nipple measurements prior to surgery. It's common that there are differences. Unless they are addressed during surgery they will remain after the procedure. The space between your breasts is determined by your anatomy. During surgery there may be techniques to give the illusion the breasts are closer together, but the actual width cannot be changed. I encourage you to speak with your surgeon about your concerns.