Is the PS at Fault if my Implants Go to Far Towards/Under Armpits? (photo)

My implants are about 4mths old, When i lay down they move right under my armpit and sit down my ribs low. What can be done and did the PS make the pocket to big? should he fix it at cost?.

Doctor Answers 21

Large implants falling towards armpit after breast augmentation

Based on your after photos, it does appear as though you have inferior-lateral migration of your breast implants. A before photo is definitely needed to give you a more definitive diagnosis, but some conclusions can be drawn from the following observations:

  • Your augmentation was sub-glandular
  • Your prosthesis are relatively large
  • You appear to have laterally located nipple-areola complexes (NAC) which suggests that your breasts were somewhat far apart to begin with

Given that sub-glandular placement does not support breast prostheses as well as sub-pectoral and that breasts augmentation can amplify underlying characteristic after augmentation (e.g. breasts that laterally drift to the side prior to surgery will laterally drift to the side - or more so if the implant is too large), if your surgeon had placed the prostheses in a more medial position, the result would have been more lateral NAC positioning. In other words, the more the breast mound is pulled in towards the middle (via a capsulorrhaphy), the further out to the side your nipple areola complexes will end up.

I you do decide to have a revision, my recommendations would most likely be:

  • Switch to a sub muscular position (for support)
  • Utilize slightly smaller prostheses (to minimize further stretching of the skin tissue)
  • If recommended, agree to have a lift (to obtain better positioning and remove any sagging)

Albany Plastic Surgeon
4.9 out of 5 stars 181 reviews

Talk to PS about Capsulorrhaphy

The implant pocket can be modified to prevent this from happening. The revision is technically referred to as a capsulorrhaphy. Please discuss payment guidelines with your PS as a part of the revision may be covered.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 24 reviews

Large gap between implants

Your breasts will certainly improve in shape over the next 6 months since you are very early in the post operative recovery process. The distance between the breast is determined by several factors.
This included the anatomy of your chest and sternum. Since the implant, if placed under the muscle, can only go as close to the middle as the edge of your breast bone this is one limiting factor. If the rib cage is flat the breast will project forward, if it is angled they will project to the side. These are all factors that can be discussed with your plastic surgeon.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Implant pocket may be too big


It sounds and looks like your implant pocket is too big on both sides.  This can be repaired by a "capsullorhapy" or repair of the implant pocket/capsule.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Implants that go to far towards the armpits

There are several reasons why implants may fall too far to the sides when you lie down.  Yes, it is possible that the pockets were made too far laterally, but this should reveal itself very quickly after surgery.  The pockets can be made perfectly, and yet a patient's tissues may stretch over time due to the weight of the implants...the larger the implants and the thinner a patient's tissues, the more likely it is that this may occur.  Post-operative stretching of this nature cannot be controlled by the surgeon, and there is no question that larger, heavy implants have more problems in this regard.  Also, patients who have certain ribcage shapes, such as laterally tipped ribs, will have implants that settle farther apart when the patient is upright, and those patients are at higher risk for implants that stretch the tissues and fall too far to the sides when lying down.  Patients oftentimes do not realize that not everyone can have the result they want if they do not have the anatomy that will cooperate.  Thin tissues, the use of large heavy implants, wide separation between the breasts, constricted breast deformity, ribcage shape...these all effect what result you achieve.  Breast augmentation is not magic, and it is the responsibility of the surgeon to make sure their patients understand what can be controlled and what cannot.

In your case, it appears that you have larger implants, and we do not see a preoperative photo. Again, larger implants will stretch your tissues more over time, especially if you are a slender person with thinner tissues. If your breasts are low on your chest, the implants will be low as well since the bottom of the implant is at the level of the inframammary crease. If you had somewhat sagging breasts that were filled out by the implants, remember that implants do not lift breasts, they just fill them out.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Positioning of breast implants

The implants can migrate outwards if the implants are too heavy, if the tissue does not provide enough support and if the pocket has been created too large.

Without seeing a 'before' picture it is difficult to know the exact cause of the problem, but you may need a revision with a smaller/tighter pocket and possibly a lift.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon
4.8 out of 5 stars 32 reviews

Is the PS at Fault if my Implants Go to Far Towards/Under Armpits? (photo)

Hi Jodyanne.

Your plastic surgeon must place your implants where Mother Nature has placed your breasts and nipples.

Your nipples sit far out in the direction of your sides. Therefore your implants sit out to the sides.  If they did not, and sat close together near the center of your chest, then your nipples would be way out on the outsides of your breasts pointing sideways.

I ALWAYS discuss these issues with my patients before surgery. There is no disappointment when people know exactly what to expect.

Finally, you don't tell us what type of implant you have. You probably know that saline implants are heavier than silicone gel devices and do have more of a tendency to fall out to the side over time.


Eric Pugash, MD
Vancouver Plastic Surgeon
4.9 out of 5 stars 136 reviews

Implant position

Many times the pockets become larger due to the poor quality of tissues.  It can also happen with the pockets being created too large.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Did my Plastic Surgeon make the Breast Implant pockets too big?

Hard to assign singular blame when we do not have all the facts and when it is obvious that your result could be due to your choice of large breast implants.

Despite everything you read here and other less reputable websites, there is a finite limit on how large an implant can be squeezed into the average woman's chest. We refer to the LAWS of Physics Gravity, Momentum Inertia as laws because they always occur and do not make exceptions. When you critically look at your chest, you have a narrow flat landing on which the implant can sit facing forward without sliding sideways). By picking implants which are significantly wider than this area, the implant base exceeds the flat area and tips sideways. This would happen even if you lived in a gravitation free environment. Add gravity to this situation and in addition to the wider implant base you now have a gravitational pull inferiorly and to the side caused by the implants resulting in the look you do not like. Bottom line - large implants in a petite feminine sloped chest will do it.

Your options - live with it, put up with it until the implants need to be changed or change it surgically. Correcting it surgically is more involved than the original operation and as a result more expensive.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Is the PS at Fault if my Implants Go to Far Towards/Under Armpits? (photo)

Very difficult to lay blame to the PS. You have lateral displacement and some bottoming out. Seek second opinions in person from boarded PSs in LA

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.