Something doesn't look right am I bottoming out? Breast do not look "round", fall toward my armpits when laying down. (photo)

I'm 5'3 107lbs. 4 months post-op, I have 375cc silicone under the muscle implants. After my surgery I had a hematoma in my right breast & the doc said he may have over dissected the pocket. When I lay down my boob gets flat and falls toward my armpit and is quite uncomfortable. I also have rippling that comes & goes. Am I bottoming out or are the implants too large for me? When I lie down they just kinda of slide apart of each other. Not sure how to have breast corrected? Thanks for any help!!

Doctor Answers 8

Implants are out of position.

The pocket space does seem to be over dissected. A hematoma is not caused by over dissection, but having a hematoma can stretch out the pocket. Regardless, the issue appears to be implant malposition. Size may also contribute, although 375cc implants are not typically "large" implants. An in person consultation would be necessary for any further detailed recommendations.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Implant malposition

These are large implants, but only you can decide whether they are too large for you.  The space does need to be corrected.

Gary Lawton, MD, FACS
San Antonio Plastic Surgeon
4.9 out of 5 stars 136 reviews

Something wrong

So it is difficult to speculate exactly what happened in the operating room as only your surgeon knows exactly what happened. Are the implants too big for you, it appears they are likely bigger than your chest width can handle(that volume and profile chosen), the pocket was possibly over dissected laterally and inferiorly, again tough to speculate as only your surgeon was in the operating room. A hematoma post-op can definitely cause problems. Rippling has to do with your breast and muscle coverage, you are small and thin, likely had small breasts prior to this augmentation, so at this point harvesting some fat from somewhere(your abdomen or anywhere you have some to harvest) and transferring to the areas that ripple to obtain more coverage over the implant would be a good strategy at this point, a "composite" breast augmentation. Another option would be to switch to an anatomic "gummy bear" implant as they do not ripple like silicone or saline implants do. Switching to a smaller size and correcting the capsule would also be an option. At this point discussing your issues/desires with your surgeon or seeking a second opinion would be your best plan of action.

Something doesn't look right.

Thank you for sharing your question and experience. It does appear that your implants are a bit large/wide for your body frame and that you may be experiencing some implant malposition issues as your implants slide off of your chest and into your armpit. If a physical exam confirms this, a revision could be done 6 months after surgery to reduce the size of your implant pocket and exchange your implants for a narrower/higher profile implant.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 68 reviews

Am I bottoming out with my breast augmentation?

Thanks for the question.  There should be very limited movement to a breast implant in the breast pocket, but if you notice that the implants slide to the side of the breast or fall below the breast fold you may be experiencing a bottoming out and lateral displacement abnormality.  This is still early to make a change or correction( if it ever proves to be need d), but I would continue to let your Plastic Surgeon see you and offer further evaluation.
Good luck to you.
Frank Rieger M.D.  Tampa Plastic Surgeon

Large Implants

Sorry to hear you are having problems with your implants. By looking at your pictures it does appear that you have wide implants for your body frame but a physical exam will be required to confirm that. If you indeed have that exchanging the implants to narrower ones as well as correction of your pockets with capsule correction will be needed.
Good luck!

Something doesn't look right am I bottoming out? Breast do not look "round", fall toward my armpits when laying down.

I am sorry to hear about your concerns after breast augmentation surgery. Based on your description and photographs, it is possible that you are experiencing a breast implant displacement (lateral and inferior) problem.  In other words, the breast implants may be too low down on your chest wall when standing and "fall" off to the sides when you lie down.
Generally, the lateral and inferior (bottoming out) breast implant displacement can be corrected using an internal suture technique (capsulorraphy), decreasing the size of the pockets and moving the implants toward the midline.    Doing so will prevent the breast implants from migrating to the sides when you lie down and will help centralize the position on the breast mounds. In my practice, this repair is done with a 2 layered permanent suture technique. The use of acellular dermal matrix is an option ( although not usually necessary)  especially if significant implant rippling/palpability is present.  I hope this (and the attached link) helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Implant position

Thank you for your question.When you are upright the implants look like they are in a decent position from the photos. But you are correct that when you lay down they should not be going into your armpits. When this happens it means the pocket around the implant is too big, so the implant is just floating around in there instead of being nice and snug. To correct this, you go in through the same incision the implant was place and use a permanent stitch to tighten the capsule.  I would suggest contacting your surgeon to see if this is what you need. Good luck.

Francis Johns, MD
Greensburg Plastic Surgeon
4.8 out of 5 stars 73 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.