Updated for 2019.
Breast augmentation is one of the most common cosmetic surgery procedures performed in the U.S. Millions of women are extremely pleased with their breast augmentation results. This outpatient procedure is relatively short, very safe and complications are rare.
Occasionally, implants can shift out of position and especially when lying flat on your back they can move too far to the sides.
In almost all cases, when a woman lies on her back her breasts (and implants) shift to the side. But if the implants shift too far to the side, it can distort the shape of the breast. The implants should be centered behind the breast and nipples and they should maintain this relative position when a woman moves.
If the implants shift too far to the sides, the nipples tend to point towards the middle, the sides of the breasts bulge outward and the space between the breasts widens dramatically and flattens out. Occasionally, this movement may also be uncomfortable and some women may feel self-conscious about their breast appearance.
Loose Breast Implant Pockets
Excessive movement of breast implants behind the breasts is generally the result of the implant pocket being too big for the implant itself. This provides too much room for the implant to move and allows it to shift out from behind the central portion of the breast. Most commonly, this is caused by the implants being too large or heavy for the breast tissues to support and hold in place.
As time goes by, continued pressure on the breast tissue causes it to stretch and expand the breast implant pocket. Less commonly, an excessively large breast implant pocket can be the result of over-dissection of the pocket at the time of augmentation.
What Can Be Done
Fortunately, this situation is uncommon and can be treated. A surgical procedure known as a capsulorrhaphy can correct this problem. This procedure tightens the breast implant pocket, decreasing the mobility of the implant within the pocket and re-centers the implant back behind the breast and nipple. This can often be done without having to remove the implants during the healing phase and then returning to the O.R. to place new breast implants.
After surgery it is important, however, that every effort be made to keep the weight and pressure of the implants from straining the breast pocket repair and causing it to fail. Usually wearing a bra that holds the breast together and away from the sides for about 6 to 8 weeks will be adequate. The bra should be worn throughout the day and especially at night when the curvature of the chest tends to allow gravity to pull the implants back to the sides.
Using Mesh to Stabilize the Implant
It may be difficult to keep the weight of the implants off of the breast pocket repair when the breast implants are large and heavy. In such cases, a biological mesh (such as SERI) may be used to reinforce the capsulorrhaphy and minimize the risk of failure of the repair.
The mesh increases the strength of the repair and over many months it is slowly reabsorbed by the body and replaced with natural tissues. These tissues are quite strong and continue to provide excellent support for the implant so that widening of the breast implant pocket does not recur.
Breast Implant Revision with Dr. Nein
Dr. Nein has treated a number of women who have been referred for treatment of breast implants that are too far apart. The advanced techniques he has used to correct these deformities have proven to be very successful.
These women have been very pleased with the repositioning of the breast implants and after complete recovery are able to lie back without being embarrassed about their breast movement. These procedures are performed as an outpatient and recovery is similar to the initial breast augmentation.