My breast implant (surgery 40 days ago, 300cc, silicone, round, dual plane) is distorted upon muscle flexing. Can this be corrected? Can muscle that is cut in dual plane positioning be joined back together and replace positioning with split muscle technique? Does split muscle completely prevent implant distortion?
Muscle Contracture Implant Distortion
Doctor Answers (5)
Revision breast augmentation can be done in several ways.
It does look like you need a revision, and that the right breast is lower than the other. Without examining you, I would say your best bet is probably to place the implants on top of the muscle.
This is how it's done in Europe most of the time, and it is a great technique for the right patient, which you seem to be.
To avoid this problem I recommend textured gel implants under the breast if the patient has enough soft tissue
When the implants are placed under the muscle there will always be movement of the implants with contraction of the muscles. To avoid this problem I recommend the placement of textured silicone gel implants through a periareolar incision (around the nipple areolar complex) under the breast. This not only avoids this movement of the implants with muscle contraction, it also gives the most natural feeling and appearing result. The only real problem with this approach is if the patient does not have enough soft tissue in the breast to cover the implant, this may lead to palpable or visible ripples or folds. While this can be avoided by selecting only patients with enough soft tissue, it can also be corrected by fat grafting to the breast in the areas of ripples to hide the ripples.
The simplest procedure to correct this deformity is to move the implant to the above the muscle position. This will allow for repositioning the implants so that they can be more symmetrical. If you prefer the implant under the muscle, or your surgeon has a good reason to keep them under the muscle, you will need to use one of the biological materials-Alloderm or Strattice- to bridge the space between the edge of the muscle and the rib from which it was release so that it can't contract upward any more.
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Split muscle technique corrects muscle flexion distortion
Thank you for attaching the pictures, which show a classic animation problem related to the detachment of the muscle with the dual plane technique. The split muscle method is very effective at avoiding this because the muscle is not cut from its attachment to the ribs. It is also useful for correcting the type of problem that your pictures show. There are a few examples on my website - see "corrective procedures" in the breast section. I can also send you a copy of my article describing the technique in more detail.
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