Muscle indentation in breast implant? (Photo)

Question

I have recently noticed that I can see a slight indentation where my muscle is over my breast implant. I was wondering if this is a normal thing or if I should be concerned? Is this capsular contracture? None of my breasts are hard and neither of them look higher up on the chest. Everything feels fine I'm just concerned. The left breast. 6 month post op.

Gianfranco Frojo, MD · Answer

This is from poor incision planning and over-release of the pectoralis muscle. You are seeing the inferior border of the pectoralis muscle and also a poorly planned incision line. Now that the implant was descended, the lower pole skin has stretched and the original incision in the fold is now displaced on to the lower pole of the new breast skin that was been recruited to the breast from the torso skin as the implant stretches the soft tissues.

Daniel Barrett, MD · Answer

Dear MaddieFlowers,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

A combination of implant capsule attachment to muscle and retraction of breast tissue would create this type of deformity. Release of capsule and  separation of  muscle/breast  tissues, sometimes addition of fat grafts, should correct this deformity. It is in your best interest to first address this issue with your surgeon. Good luck.

Gerald Minniti, MD, FACS · Answer

The implant has descended under your native inframammary fold. This will require a surgery to close that portion of the pocket, known as capsulorrhaphy. This is now commonly done with the assistance of a resorbable mesh to increase durability and predictability of repair.

Connie Hiers, MD, FACS · Answer

You have what is called a "double bubble" on that side. It does not have to be fixed if you are ok with it. Do wear a good supporting bra in the day so that it does not get worse. If you have any concerns, please go back to your surgeon.

Camille Cash, MD · Answer

It appears you have developed a double bubble.  Sometimes we use bioabsorbable mesh to help support the tissues to keep this from occurring again in the future.  I encourage you to visit with your surgeon for an evaluation.  I've included a video on mesh that I hope you find helpful.

Daniel P. Markmann, MD · Answer

Thank you for the question and the pictures.   Actually, you have what is called a double bubble.   That indentation that you are seeing is actually your old crease.  That is to say, that indentation used to be at your chest wall and was your crease before implants.   This can usually be fixed or at least improved upon by releasing the remaining muscle attachments to the crease or by moving the implants to above the muscle.

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