Has my left implant slipped or is it something else? (photos)

I have 397cc round silicone breast implants under the muscle. I originally got them in June of 2014. I had the left revised a year later. It has been a year since my revision and the same thing has happened to my left breast. It is flat on top and appears, to me anyway too big in bottom. It is also to far to the side. It feels like I can push the edge of the implant when I push on the bottom of my left breast. I cannot feel this on my right. What is wrong with my breast and can this be fixed?

Doctor Answers 3

Revision breast surgery

It appears your left breast is in improper position and has bottomed out, this can be fixed with use of internal suturing techniques with or without a mesh to help hold things up. The right breast implant appears to be in a good position.

Breast implant displacement concerns…

I am sorry to hear about/see the problems you are having after breast augmentation/lifting surgery. I think your concerns are appropriate; your breast implant does seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”).  
I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation. 
In my practice, this type of repair involves a two layer, permanent suture repair (reconstructing the inframammary fold areas). Sometimes, depending on the clinical situation and history, the use of additional support materials such as acellular dermal matrix or biosynthetic mesh is also helpful.

 I would suggest that you communicate your concerns again directly with your plastic surgeon. Working together you arrive at the best plan (for example to operate on one or both breasts) to achieve an outcome that you will be happier with.

I hope this, and the attached link (dedicated to corrective surgery for bottoming out concerns), helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,484 reviews

About Breast Implants "Bottoming Out"

"Bottoming Out" is the term given to implant #displacement, where the implant drops down below the existing inframammary fold; the natural crease beneath your breast. This may occur when the fold has been released excessively during surgery or may be due to factors of the patient’s collagen and tissue integrity. The implants then sit very low on the chest with a lack of internal support for the implant itself.
Correction usually involves #restoring the crease beneath your breast to it's normal position with internal reconstruction of the capsule around the implant (#capsulorrhaphy). Sometimes a biologic fabric (Acellular Dermal Matrix or #ADM) can be used to attach to the breast tissue internally while supporting the implant.
This corrects the placement of the implant, redefines the breast shape, and also refines the internal fold. However, it is best to consult with your Plastic Surgeon to better confirm with an in-person exam.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 107 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.