The problems arise when there is too much lateral (to the side) breast fullness and not a lot of cleavage. This is lateral displacement and is what happens when breast implants fall too much to the side. In extreme cases, they may end up under a woman’s armpits. This is usually caused by surgical error and can happen with implants placed over or under the muscle. Typical patient complaints are that the implants are in “my armpits” or that “I keep hitting the sides of the breast with my arms.” This is not to be confused with not enough cleavage due to too narrow an implant. Sometimes implants will look great for some time after surgery, but the action of the muscle pushes the implants to the side over time.

Lateral displacement may or may not be seen when a woman is upright but will be seen when a woman reclines. In our consultation, we perform a “tilt test” in which the patient sits in an exam chair with her arms on the handles then the table is tilted back to see the extent of the lateral shift. 

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Correction of lateral displacement depends upon what caused the problem and whether the implants are over or under the muscle. If the implants are under the muscle correction is either done through one of two ways depending upon examination and capsule thickness.

Capsulorraphy

This is when the capsule at the side is closed off or tightened.

The incision used is the same as in the original surgery: areolar (nipple) or inframammary (under the breast). Mesh (GalaFlex or Strattice) may be used for additional support.

If the original surgery was transaxillary (armpit) or transumbilical (belly button) the patient is given the choice of areolar or inframammary incisions. The capsule is opened and the implant removed. The lateral pocket is tightened as above and mesh may be used for additional support. The implant is replaced (or new implant) and the incisions are closed. A drain may be placed if Strattice is used.

Strattice is often placed to correct laterally or inferiorly displaced implants.

Neopectoral pocket

In this case, the implant is removed and the capsule under the muscle (anterior side) is dissected off the muscle and a new pocket is created on top of the old capsule. A new implant (or the old one) is placed in the new (neopectoral) pocket. Sometimes Strattice or Galaflex is used for additional support. A drain may be used for a few days to a week and the post-operative instructions are the same as for capsulorraphy.

If the original implant was placed over the muscle, conversion to under the muscle will correct the lateral displacement (and rippling). Sometimes Strattice or Galaflex is used to help support the implant. 

In some cases, a woman has a nipple-areolar complex that is lateral to start with (nipple is not centered) and the plastic surgeon places the implant directly behind the nipple – the implant ends up too lateral and there is no cleavage. This is corrected by fixing the pocket and moving the nipple towards the center. 

Procedure and Recovery

This surgery is performed on an outpatient basis and you should arrange for someone to drive you home after your surgery and stay with you overnight. There will be some pain and swelling for a couple of days after surgery, and you will have prescription pain medication to help you stay comfortable in the early stages of healing. Soreness and swelling may last up to several weeks.

You will be seen the next day in the office and the surgical wrap removed. You will be placed in a soft bra that we'll provide. After you return you may shower and replace the bra provided. You will be seen a few days later for a follow-up to assess healing. Wear the bra provided until our staff says otherwise. You will be placed in an underwire bra for support by our staff. You may be asked to bring in a few of your old underwire bras to assess fit. Avoid buying new bras until we recommend them.

Here is a general timeline of breast lift recovery:

  • One day to one week before you can return to work (depending on the surgery performed and your job)
  • Driving – about four days
  • Exercise — generally two to four weeks, depending upon the surgery performed
  • Golf and tennis may be resumed about four weeks after surgery
  • You can wear underwire bras after being cleared by our staff

Schedule Your Consultation

We would love to talk more with you about your own personalized treatment at Sanctuary Plastic Surgery. With your own private consultation, our team of extraordinarily skilled and dedicated plastic surgeons will be able to recommend the right treatment plans for your unique goals and concerns. With offices in Boca Raton and Palm Beach Gardens, men and women in Florida can achieve the most natural and elegant results. Call today to schedule your consultation.

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