I am 5'8" in height and weighing 138 lbs. I'm in good shape--I jog, do push ups, and light weights. I've nursed 3 children for the last 5 years. I have 425 cc implants placed partially submuscular a year ago. The slightest flex of chest muscle makes my breasts appear unnatural. It makes the implants move upward while the bottom part ripples out. It's becoming more obvious over time. Overall, my breasts look natural and pleasant the muscle is relaxed. But to keep this from worsening, can one go from under the muscle implants to over?
January 29, 2019
Answer: Hyperanimation deformity YES!! You sound like a perfect candidate for a subfascial conversion assuming you have sufficient soft tissue coverage to camouflage the implants. Generally speaking, if you have at least 2cm of "pinch" in the upper pole of the breast, you would potentially be a great candidate for such conversion. You have hyperanimation which is a fairly common event following submuscular implant placement. Even with the addition of ADM in the lower pole, if you keep your implants in the dual-plane position, they are subject to the animation forces of the pec muscle and you will still have that classic unsightly contracture which can also be uncomfortable. This is a fairly routine procedure whereby in addition to the subfascial conversion, a piece of mesh is utilized to stabilize the implant, minimize rippling, and provide a long lasting result. Some patients who are thin may require secondary fat grafting if there is any associated rippling. Talk to your board-cerftified plastic surgeon about this.
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January 29, 2019
Answer: Hyperanimation deformity YES!! You sound like a perfect candidate for a subfascial conversion assuming you have sufficient soft tissue coverage to camouflage the implants. Generally speaking, if you have at least 2cm of "pinch" in the upper pole of the breast, you would potentially be a great candidate for such conversion. You have hyperanimation which is a fairly common event following submuscular implant placement. Even with the addition of ADM in the lower pole, if you keep your implants in the dual-plane position, they are subject to the animation forces of the pec muscle and you will still have that classic unsightly contracture which can also be uncomfortable. This is a fairly routine procedure whereby in addition to the subfascial conversion, a piece of mesh is utilized to stabilize the implant, minimize rippling, and provide a long lasting result. Some patients who are thin may require secondary fat grafting if there is any associated rippling. Talk to your board-cerftified plastic surgeon about this.
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March 8, 2018
Answer: Animation deformity Hello, thank you for submitting your pictures and providing such a good description. You have what’s called an “animation deformity”.
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March 8, 2018
Answer: Animation deformity Hello, thank you for submitting your pictures and providing such a good description. You have what’s called an “animation deformity”.
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December 13, 2017
Answer: Animation Deformity with Subpectoral Breast Implants Thank you for your question. Yes, is it very possible in revision breast surgery to do a "site change" and change the breast implants from the subpectoral pocket (under the muscle) to the subglandular pocket (above the muscle); however, it is not without some trade-offs. All patients that have breast implants under the muscle will have some degree of "animation deformity" which means that there can be movement and indentation lines seen usually in the lower part of the breast area when the pectoralis muscle (chest muscle) is flexed. Sometimes it can be very subtle and other times it can be more of a nuisance or concern. Each patient is different and each patient's muscles are different. This variation can also have to do with "where" and "how much" of the inferior slips (lower portion) of the pectoralis msucle was "released" at the time of surgery. One option in my opinion to help with this would be to consider a revision of the breast pocket to evaluate the muscle and capsule. Sometimes, it can be found that there was an under-release of muscle that can be released a little more, and a simple "dual-plane" release of the muscular attachments to the skin can be done which can improve the animation significantly. Other times, I might consider a neosubpectoral pocket change and dual-plane release to release some of the overlying skin attachments to the muscle. I think these options can improve the animation deformity, but it still may not go completely away. If you absolutely want no movement of the implant at all with flexion of the pectoralis muscle, then I would recommend a site change to the subglandular pocket as you query above. This does involve some trade-offs such as an increased risk of capsular contraction and more possible visible rippling and wrinkling of the implants;however, many patients do quite well with subglandular breast implants. If you choose to go subglandular, then I think it would be important to consider using a more cohesive silicone gel breast implant with a higher gel-to-shell ratio to have the least chance of implant rippling. This is something to ask your plastic surgeon about.I dedicate a large portion of my practice to aesthetic breast surgery revision, and I think it is important to discuss your concerns and options with one or several board certified plastic surgeons that specialize in aesthetic breast surgery revision. I hope this is helpful. Good luck!
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December 13, 2017
Answer: Animation Deformity with Subpectoral Breast Implants Thank you for your question. Yes, is it very possible in revision breast surgery to do a "site change" and change the breast implants from the subpectoral pocket (under the muscle) to the subglandular pocket (above the muscle); however, it is not without some trade-offs. All patients that have breast implants under the muscle will have some degree of "animation deformity" which means that there can be movement and indentation lines seen usually in the lower part of the breast area when the pectoralis muscle (chest muscle) is flexed. Sometimes it can be very subtle and other times it can be more of a nuisance or concern. Each patient is different and each patient's muscles are different. This variation can also have to do with "where" and "how much" of the inferior slips (lower portion) of the pectoralis msucle was "released" at the time of surgery. One option in my opinion to help with this would be to consider a revision of the breast pocket to evaluate the muscle and capsule. Sometimes, it can be found that there was an under-release of muscle that can be released a little more, and a simple "dual-plane" release of the muscular attachments to the skin can be done which can improve the animation significantly. Other times, I might consider a neosubpectoral pocket change and dual-plane release to release some of the overlying skin attachments to the muscle. I think these options can improve the animation deformity, but it still may not go completely away. If you absolutely want no movement of the implant at all with flexion of the pectoralis muscle, then I would recommend a site change to the subglandular pocket as you query above. This does involve some trade-offs such as an increased risk of capsular contraction and more possible visible rippling and wrinkling of the implants;however, many patients do quite well with subglandular breast implants. If you choose to go subglandular, then I think it would be important to consider using a more cohesive silicone gel breast implant with a higher gel-to-shell ratio to have the least chance of implant rippling. This is something to ask your plastic surgeon about.I dedicate a large portion of my practice to aesthetic breast surgery revision, and I think it is important to discuss your concerns and options with one or several board certified plastic surgeons that specialize in aesthetic breast surgery revision. I hope this is helpful. Good luck!
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