How to Fix a Breast Implant That Sits Too Low

If one of your implants ends up sitting lower than expected after surgery, the fix depends on how quickly you catch it and how far the implant has shifted.

If you notice the problem early, within the first two weeks, there is some evidence that wearing an underwire bra consistently for a couple of weeks can actually correct mild malposition. It works by supporting the implant and helping scar tissue form along the crease so it heals in a better position.

The key is starting quickly. If you're in that window, it's worth a shot before considering anything surgical.

If you didn't catch it early or the malposition is more significant, this becomes a surgical problem and part of breast revision. There are three main approaches:

This involves using a cautery device to burn the capsule tissue in the lower portion where the implant sits. The goal is to tighten things up and encourage the implant to sit higher. Honestly, this is not my favorite method by itself, because I don't think it works well as a standalone fix.

Instead of just burning the capsule, we suture (sew) the capsule to tighten it. I think this is a better method, and when I perform this procedure, I actually combine both techniques: I'll cauterize the capsule to create a raw surface and then oversew it with heavy-duty stitches.

An important note on suture material: I strongly prefer absorbable stitches around implants. Permanent stitches are a biofilm magnet, and I don't recommend them near implant surfaces.

When the capsule is thin, my usual approach is to add mesh or surgical scaffolding. I like the brands TIGR Matrix and GalaFLEX. These products are used off-label in the breast, but plastic surgeons use them often. You could also use dermal matrix, though it tends to stretch and isn't as consistent.

The reason comes down to biology. Many patients with implant malposition simply make thinner capsule tissue than their body needs to support the implant. Trying to suture thin, wimpy capsule is like "sewing snot to moonbeams." It just won't hold.

Augmenting that weak capsule with a surgical scaffold gives it the structural support it needs.

If you're someone with normal capsule thickness, for example someone whose crease was lowered during the original surgery (which sets things up to drop, because a surgically created crease is never as strong as a natural one), then capsulorrhaphy without mesh can be a reasonable first approach.

• Caught early (within 2 weeks)? Try an underwire bra first
• Mild malposition with normal capsule? Suture capsulorrhaphy may work
• Significant drop or thin capsule? Mesh scaffolding is usually my approach
• Always use absorbable sutures around implants to reduce biofilm risk