Muscle Distortion, Bottoming Out and Deformity in Both Breasts

I had Breast Augmentation with an uplift in Feb 2010,to regain my fullness,i had 255cc in each breast. in Aug 2010 had a re-opp due to muscle distortion in my right breast & my left had bottomed out and needed uplifting more, now,6 months later still feel i have the same problems, my right breast looks deformed when i tense my muscle and my left implant feels like it overlaps when i bend over,it feels strange against my chest wall & nipple is across to the left, do i need a re-op?

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11 Doctor Answers | Asked by myself29

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Muscle Distortion, Bottoming Out and Deformity in Both Breasts

Thanks for the photos and your description. You are in a very difficult position. Of course you need revision but what type and by who? I have undertaken these difficult revisions by offering a staged repair options. From your photos my stage I is removal change position to subglandular with Alloderm and textured or smooth HP implant around 350 cc's. Or use an expander implant instead. Stage to adjustments via lifting techniques. Final stage any fat transfer to even things out. Best... more

Correction of bottoming out and animation with breast aug - important to get it right

One of the problems that plastic surgeons don't talk about enough is animation distortion, which actually affects 70% of patients to some degree when the implants are placed under the muscle using the traditional (dual-plane) technique. That is because the muscle is cut from its attachment to the rib cage, and it then heals to the scar capsule as it forms around the implant, so that it pulls on the breast. Often a double-bubble contour forms for the same reason. To make matters worse... more

TO REVISE OR NOT TO REVISE

It appears you have answered your own question. My vote is for revision. I feel the easiest means of correcting both issues is to place the implants under the tissues. The muscle deformity will be a non issue. The pocket will be recreated on the left correcting the bottoming out issue. I would not wait. Discuss another revision with your surgeon. I am certain he will give you a discount whereas another surgeon will charge you full price. If money is... more

Muscle Distortion, Bottoming Out and Deformity in Both Breasts

It appears you have ahd many excellent recommendations. Your right appearas smaller and above the muscel so muscle release may be required with or without a larger implant or learn to not contract the pectoralis. Your left mayrequire another lift or caspulorrhapy or downsizing. Measurements and examination will help with this decision.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

The 3rd operation

You should undergo another surgery to repair this distortion. It looks like the main problem is the right sided muscle distortion which can be addressed at another surgery. The best thing about combining a lift and augmentation is that you only undergo one operation and one recovery - but a downfall to combining the procedures is that revision surgery is very common (12-16%) and you unfortunately fall into this group. Good luck!

You need a diagnosis.

Your photos present an interesting problem. You have right breast distortion with pectorals muscle flexion without apparent compression of the implant. My best guess without examining you is that the original operation was above the muscle and that subsequent sub muscular placement didn't work. I feel that the implant is still above the muscle and that the muscle is lifting the implant from behind. Effectively pushing the implant back to a sub glandular placement. The key to successful... more

Bad breast aug

Unfortunately, as you may have come to the conclusion on your own, the result today is not great. It's certainly not what you had in mind, but I'm willing to bet that it's also not what your surgeon had in mind. Somethings are totally out of both of your control. The solution much to your satisfaction is out there! I think that if your implants were to be removed of all of that scar tissue and they were to be placed in the correct location then... more

Muscle distortion after breast implants

Muscle distortion is 'the' problem with under the muscle breast implants. The implant will flex and deform if the chest muscle is contracted tightly. The effect if minimized if the implant fills out the breast skin envelope well. When augmentation is combined with a breast lift, especially with a smaller implant the miss-match between the implant and skin is greater and with flexing the implant can move beneath the breast in a disconnected way. We recommend that you consider a... more

Breast issues

Three strikes and your out! Be careful underoing so many re-ops. Your right and left breasts are different, with the left one being much largee than the right. They will never be exactly the same. You may want to reduce the left side and leave them alone.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Breast augmentation -getting it right the first time

You are going down a problematic road -2 operations within a year and already looking at a third operation. There are multiple issues here. In the photos the left breast is larger than the right and lies lower on the chest wall, the nipples point out to the sides rather than straight forward, the right breast has more capsular contracture with implant deformation than the left and the right implant deforms even more with certain muscle activation. From the information in your post alone... more

Deformity after Breast Surgery

Your deformities are complex. Essentially you are describing an "animation deformity" resulting in abnormal appearance when your pectoralis muscle is contracted. You also have some asymmetry with the left breast lower than the right. There are several ways to correct this, and all involve reoperation. I would recommend seeing a plastic surgeon experienced with the use of newer biologic materials such as Alloderm or Strattice. This may provide a way to reconstruct your breast... more