Lateral Displacement of Implants (Wide Cleavage)

INDIANAPOLIS, IN – When implants move too far to the outside edge of the chest, the IMD (intermammary distance) is increased and the cleavage is decreased. This is typically most noticeable when lying down.As the implants move laterally, a wide flat space is often left over the breastbone. This can occur when the “pocket” for the implants is too large or when it has been stretched. Sometimes this is because a patient has very loose elastic tissues. Patients should be encouraged not to sleep on their stomach as this will only further stress the lateral (outer) breast tissues.

Correction can be achieved surgically by reinforcing the lateral boundary of the breast pocket (the outer tissues at the side of the chest) and “plicating” or closing this “pocket” around the implant at the side of the chest. After removing the implant the edges of the pocket are sutured together with a permanent suture to essentially “force” the implant more medially, (toward the center of the chest).This restricts the movement of the implants away from the midline and increases the cleavage (and decreases the IMD).

This patient of the Gillian Institute in Indianapolis Indiana came to Dr. Short because her breasts were firm, displaced laterally and she had developed a large space between the breasts due to the contractures.She had her implants placed in another state several years before.Since she was going back to surgery she also decided to “go a little larger”.Dr. Short removed the contracture scar tissue, replaced her implants and reshaped the pocket to give her more cleavage and a prettier breast shape. This was all performed through her previous small incisions.

This patient’s main goal was to increase her cleavage without increasing her size.Dr. Short had previously placed her implants through a transaxillary incision (incision in the armpit).Her implants had moved outward over time due strong muscular contraction as the implants were placed under the muscle.She preferred not to have an increase in size, just more cleavage and she wanted to use the transaxillary incision again.This incision makes it impossible to suture the lateral border of the breast pocket.Dr. Short was able to accomplish a moderate increase in cleavage however, by using a different profile implant which had an increased width (increased diameter) but a similar projection.This approach achieved her increase in cleavage through the transaxillary incision without increasing her size significantly and without suturing of the capsule.

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