AboutAlan M. Engler, MD, FACS Expertise Dr. Engler has answered over 2100 plastic surgery questions for Allexperts. His expertise is in cosmetic plastic surgery including breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts etc.
Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction."
Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), and the Dr. Keith Ablow Show. Videos of his appearances are available on YouTube (SEARCH FOR "DR. ENGLER"). His website is www.bodysculpture.com.
Experience Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, etc.
Organizations belong to ASAPS (American Society for Aesthetic Plastic Surgery); ASPS (American Society of Plastic Surgeons); ACS (American College of Surgeons); Clinical Assistant Professor of Plastic Surgery at the Albert Einstein College of Medicine in New York
Question I had breast implants 3 years ago. Right after I told my doctor that I could tell that one was a little bigger and lower but I was basically told I was crazy. Now I have noticed that it sags a lot when not wearing a bra. What could this be? My implants are in front of the muscle.
Answer Hi Jennifer,
There's lots more about breast implant at my site, www.bodysculpture.com.
The positioning of implants depends on many factors. This includes how they were placed originally but also what someone's skin is like (ie, how tight or loose), whether they are under the muscle (in which case aggressive movements can displace them, temporarily or permanently) etc.
So if one is lower than the other, you have to try to figure out what is causing it. That will then determine what, if anything, is appropriate in terms of treatment. For example, if the implant is basically in the correct position but the skin has sagged over it (nothing personal, of course...) then it may be possible to lift the nipple/areola to put it in a better position. If the implant is too low it is possible to lift it and secure it with internally-placed sutures, though that can be trickier than it sounds.
In other words, you first have to figure out what the cause of the problem is and then, based on that, what is reasonable in terms of addressing it. It is, of course, best to do this with the advice of your PS but if you're still cannot get an answer you're comfortable with, you may want to seek a second opinion.
