A Melting of the Natural Breast Tissue
When a large implant is placed in the subglandular plane underneath a relatively small breast, it will exert a pressure on the undersurface of the breast. Very often this will lead to a thinning out of the natural breast tissue over time. What you are ultimately left with is skin over an implant, and under these circumstances the implant will reveal its imperfections. This is particularly true with saline breast implants.
Since I have a referral practice, I see a number of these “breast cripples” every year. The good news is that we now have a number of advanced techniques at our disposal, such a fat transfer, form stable implants, and acellular dermal matrix that have enhanced our ability to fix these breasts. That said, it would be much better if the problem were avoided from the onset by better surgical judgment.
Big Implants in Breasts That Have Settled Will Make the Breast Droop More Over Time
Natural forces have a way of always winning over time. The bigger the implant, the more gravity will stretch out the lower pole of the breast. What may look good a month after surgery will stretch out over time. A droopy breast will become a droopier breast with an implant that makes it look bottom heavy.
Some surgeons try to solve this problem by “revising” the surgery with even bigger implants. This will only further aggravate the problem over time.
If a big implant is placed under a droopy breast with a narrow width, the body’s “memory” of the original breast structure may persist and the result will be a double breast contour.
Not infrequently I see patients in consultation who originally had breasts that were relatively narrow in their base width and had settled over time.
The original surgeon may have tried to “solve” problem by placing a large, wide implant underneath the breast. This can leave the patient with a double contour. The first contour is formed by the implant; the second is formed by the original breast. This double contour can be quite frustrating for the patient.