Implants placed low on the chest

[Ina]

So, a friend of mine got a breast augmentation shortly after I did. She got interested when I started speaking of getting my breasts done, and after she saw the results she rushed to get her operation done as fast as possible. She went to the first surgeon offered and did minimal research. I had mine done in Estonia (a couple of hours from Finland and within EU so not much different than going interstate), so mine were relatively cheap compared to the bloated prices around here. She figured she would be getting better quality by paying more, sadly, as we all know, that's not how it always goes. So I feel this is partly my responsibility.

She had cohesive gels placed partially under the muscle. Her biggest concern was that the implants should not be placed high on her chest - she feels she has a long back/torso and she didn't want her breasts to emphasize that. So she asked the surgeon to place them as low as possible.

So she had her creases moved and the implants placed low, which left the nipple way up high. It's been over 6 months since her surgery and she can still see her old creases as slight shadows. They become really apparent if she flexes. On top of that she has bottomed out slightly, not by much but maybe by half an inch, on one side only. And her nipples are pointing towards the ceiling.

So, if she wanted this fixed what should she do? She has been pondering about doing a sort of a reverse crescent lift on her nipples because as it is, she's perfectly happy about where the implants sit on her chest, she's just not happy about her nipple/scar placement (the scar placement is problematic on the side that has bottomed out slightly, she had the crease incision so the scar is sitting too high on the breast). Also is there a chance her breasts will still slide further down? As I understand it she's going to want to go bigger in the future too and she's thinking about fixing the problematic areas then, would this even be viable?

All in all, if you had a patient who had concerns over her implants sitting too high on the chest, would you place them further down or just tell her her anatomy doesn't allow this? Is this even viable?

Sorry about so many questions but it's been bothering me for a while now! Also let me take this chance to thank you for participating in the discussions on the other forums too, it struck me as a very generous thing to do, offering advice on the general breast augmentation discussions too. Oh if only you weren't so far away from here I'd refer her to you

[DrSorokin]

Ina-
Without seeing her or at least a photo it is difficult to comment however I will say that it is likely an implant issue and not a nipple issue. If the implant is too low the nipple will be too high. Trying to pull the nipple down with a reverse lift (or maybe we should call it a pulldown) simply isn't going to work. I would bet that moving the implants to the proper location on her chest (which might mean recreating her original fold) would be the best way to fix her problem. At six months the implants have likely dropped to a large degree but over time if they are large implants not completely submuscular will likely continue to descend. In answer to your question about where I would place the implant in a long torso, I would center the implant on the nipple as ultimately if it is not there it is not going to look proper.
I hope this helps your friend!
Take care,
Evan Sorokin

[Ina]

That's what I thought... So ultimately it's just unrealistic expectations and unfortunately, a surgeon who went along with it rather than explain the situation. Oh well, I'll let her know, thanks for the reply!