Implant is SO high up, they look incredibly fake, and my nipples are at the bottom of the implant. What do I do?

Yes, you will need a revision to lower the implants and bring them to the middle.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Thank you for the question. In order to keep your implants from falling to the side an internal bra/capsulorraphy is needed. Also, you might need to lower the pocket around the implants.

I am  sorry to hear about your concerns after breast augmentation surgery; it would be helpful to know how long ago you had the operation performed.  Assuming that you are at least three months out of the breast augmentation procedure, given your concerns, it is likely that revisionary surgery will be necessary to achieve an outcome that you will be happier with.  Exactly what operation should be performed will depend on your physical examination and concerns. Based on the description, you may be dealing with a lateral breast implant displacement; these types of displacement problems are corrected utilizing capsuloraphgy techniques.  Also, the breast implant capsules can be adjusted so that the breast implants are not sitting so high on your chest wall;  downsizing of the breast implants may be helpful in this regard as well. Best to discuss your concerns/goals directly with your plastic surgeon. The use of goal photographs may be helpful during this communication process.  Best wishes for an outcome that you will be pleased with longer-term.

You will need a revision and there is no reason, with a skillful and experienced surgeon, that you cannot have a great result. These implants are obviously too big for your frame and the muscles have not been adequately released at the lower part of the breast so they are holding the implants too high. Get smaller implants converted to a dual plane pocket and you should do fine. 

In retrospect it appears to me that the high profile 500 mL implants were too large for your frame and your preoperative breast dimensions.  After a face-to-face examination I would consider recommending mid-profile smaller volume implants possibly combined with capsulorrhaphies and periareolar or vertical mastopexy.  Allow enough healing time for swelling to resolve but after six months you may wish to consider revisionary surgery.  Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd