What can be done to fix this muscle animation deformity on one side? (Photo)

Question

1996 saline overs 300 cc filled to 335. Oct 2015 revision 500 cc silicone unders. Within weeks bottomed out and muscle deformity. Left worse then right. 1 inch lump on sternum and left breast crossed midline. Was pectoral muscle over released? 10 weeks ago capsulahhory and fat transfer and 4 days later downsized to 400 cc (major miscommunication with PS). Left pectoral muscle aches constantly despite no exercise and right handed. Why is animation so high and what can be done to fix it?

Carlos Mata, MD, MBA, FACS · Answer

Hi SalSi,

Thanks for your question and photos. It is really hard to say what exactly needs to be done without a physical exam. It is certainly correctable with a good outcome but you will need to see a plastic surgeon that specializes in breast revision surgery. Based on your photos is appears that your muscle has been released to high and if you had symmastia or where one breast touches the other side, then you may need a complete reconstruction of your muscle, sternum, and implant. I would likely recommend dermal material to act as an internal bra. Fat transfer improves the animation deformity but it does not correct it. For it to be gone for sure the implant needs to be over the muscle! Good Luck!

All the best,

Carlos Mata MD, MBA, FACS

#animationdeformity #breastaugmentation

Board Certified Plastic Surgeon

Gerald Minniti, MD, FACS · Answer

Hello,Your muscle has been released too far and is now sitting way up high, known as window shading, and causing this deformity.  A few options include more fat grafting later, use of an ADM to reconstruct muscle origins, or reverting back to subglandular position, this time with a shaped, form stable silicone gel implant. Best of luck!

Michael C. Edwards, MD, FACS · Answer

There is no replacement for an in person exam, especially in your case, but it appear your pectoral is muscle was released off the sternum at the least to the midpoint. In general, your options involve some form of possible pectoral is extension with an acellular dermal matrix (Strattice) to try to lessen the enigmatic not deformity. A second, less aesthetically pleasing due to your thin tissues, would be to move your implants to sub-glandular. You are a thin woman and this will undoubtedly lead to I erased implant visibility (rippling and wrinkling). You need to see a board-certified plastic surgeon with experience in revision I wish you well.Dr. Edwards

Marc J. Salzman, MD, FACS (retired) · Answer

We see these animation deformities not uncommonly after patients are up sized or changed from the sub glandular to the sub muscular pocket. These can be repaired, however ,usually require a sizable piece of Strattice to attach the edge of the muscle and pull it downward towards the bottom of the pocket. I would recommend you find a plastic surgeon in your region with experience in revision cosmetic breast surgery. Best of luck.

Laura A. Sudarsky, MD (retired) · Answer

the best way to fix a hyper animation deformity of the breast  is to reposition the breast implants in front of the muscle, and cover the implants with ADM ( graft material ) to provide coverage and a new pocket. Make sure to use a board certified plastic surgeon with experience in this reconstruction procedure

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