I am 18 months post-op. When I have pectoral muscle flexion, the incision at my nipple puckers inward. (Photo)

After researching on this site, it sounds as though the scar tissue fused to the incision site, causing this unsightly deformation. My PS has offered to correct this next month, but has said that he will need to go in again and move the muscle. Please let me know if you think I will need such serious surgery, since I am very concerned about negative side effects! Are the potential side effects even worth correcting this?

Doctor Answers 10

Scar revision after breast augmentation

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Thanks for posting your question. I am happy to try and help you. Sorry to learn about your concerns.

The best advice that I can give you is that you should speak to your plastic surgeon.  This should be a relatively easy fix.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Breast Augmentation

There are no potential side effects

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This is happening because your areolar scar is adhering on underlying muscle.  Surgery is strictly optional. You can leave it alone if you choose to do so.  Only potential side effect is recurrence of this issue.

I am 18 months post-op. When I have pectoral muscle flexion, the incision at my nipple puckers inward

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Hi... thank you for the question and photo... sorry for this, the only way to correct this is with a revision and a muscle release. 

Luis A. Mejia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 78 reviews

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Animation deformity

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From the look of your photos, I would think that the fix would involve release of the scar from the deeper muscle and then placing something as a interposition graft to keep that from re-happening. In my experience, a dermal fat graft works beautifully in this regard. We can usually take part of the C-section scar or a small piece of skin just above the hairline to use for this purpose. It sounds like your plastic surgeon has a good handle on this and can hopefully correct it. Good luck.

Scar retraction due to muscle scarring

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Yes unfortunately the only way to fix this problem is surgical release of the muscle.  Good Luck.

Scar retraction requires revision

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The scar should be released so there is not this animation type deformity.  Massaging the scar may improve the look.  If this prevents a surgery, that would be an advantage.  Start with massage. The plastic surgeon is not going to move the muscle or do anything that should give you long term side effects.  If you don't like the way it looks, let them revise the scar.

Puckering of nipple after surgery

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To remedy the problem surgery is necessary. If you are not bothered by the appearance, you could leave it alone since it is an aesthetic issue rather than a medical issue. 

Scar retraction

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The correction of this requires the scar to be released from its deeper attachments and a spacer or filler placed between the ends of the divided scar tissue to try to prevent recurrence of the scar retraction.  A number of things can be used such as autologous fat transfer, a piece of acellular dermal matrix or other synthetic product such as Siri.  The risks should be on the low end for this type of procedure.

Todd C. Case, MD
Tucson Plastic Surgeon

I am 18 months post-op. When I have pectoral muscle flexion, the incision at my nipple puckers inward. (Photo)

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This is an occasional side effect of placing implants through a nipple incision. There is scar tissue tethering the skin at the incision site down to the muscle itself. In order to correct the problem, the scar tissue needs to be released and something placed in the area where the old scar tissue was. This can sometimes be fat, synthetic skin, or just sutures, depending on your surgeon's preference. 

This should be a much easier procedure than your first surgery in terms of recovery. 

Christopher D. Knotts, MD, FACS
Reston Plastic Surgeon

I am 18 months post-op. When I have pectoral muscle flexion, the incision at my nipple puckers inward.

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Thank you for your question and photograph.  It does appear that you have had some scar tissue attach your pectoral muscle to the undersurface of your nipple, causing the retraction when you fire your chest muscle.  This should not be a difficult issue to correct, as the tethered scar tissue needs to be released, and a layer of gliding tissue placed between your muscle and nipple to prevent its recurrence.  As this is largely a cosmetic issue, if the puckering does not bother you, it does not need to be corrected

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.