What Kind of Revision is Needed to Improve my Aestheitc Results? (photo)

I had 425cc HP silicone implants placed under the muscle through an inframammary incision about a year and a half ago. I have obvious issues with asymmetry, terrible animation deformity, and progressively worsening contracture on the R breast causing it to project farther off of my chest than the L. Also, I have lateral displacement of the R implant, and the L will retract almost to my clavicle upon contraction of the pec. When I bend forward, my natural breast tissue sags off of the implant.

Doctor Answers 3

What Kind of Revision is Needed to Improve my Aestheitc Results

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I don't think that you will get a good recommendation anywhere but in a plastic surgeon's office. Photo's alone, though helpful, are 2 -dimensional, and not sufficient. 

Animation occurs pretty much 100% of the time in submuscular implants. Nonetheless, most surgeons feel that the advantages outweigh the disadvantages. SInce that seems to be your main complaint, it may be that the proper option would be to move the implants above the muscle to the sub fascial position. 

As to bending forward, wherever the implant is it will be behind your breast, and in prone positions the breast will fall away from the implant. 

Capsular contractures are less common for under the muscle implants, so that would be an added risk you would be assuming. The presence or absence of a contracture is not obvious on the photos, but should be on an exam. 

Best wishes.

Seattle Plastic Surgeon

Breast Revision Needed to Improve my Aesthetic Result?

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I'm sorry to hear about the problems you are experiencing. You will be much better off seeking in person consultation with well experienced board-certified plastic surgeons who can demonstrate significant experience with revisionary breast surgery. It is very likely that a combination of breast implant capsule “adjustments” and/or breast lifting may be necessary to improve your outcome.

However, the issue of animation or flexion deformity  is difficult to improve upon significantly.  It is certainly a downside of having breast implants under the  pectoralis major muscle. Although the muscle can be released to some degree, care must be taken to avoid “overdoing” this release and causing a press implant displacement problem.  

On the other hand, there are many advantages of having the breast implants under the muscle, at least partially. Therefore, I would not suggest that you have the breast implants replaced into the sub glandular position; doing so will likely expose you to other problems.

 Again, best to seek in person consultation with plastic surgeons well-versed in revisionary breast surgery.

 I hope this, and the attached link, helps.

Sub pectoral implants will be misshapen during pectoralis function.

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The photograph is a good demonstration of the impact of pectoral function on prosthesis. The solution to the problem is to move into the sub pectoral location. There also appears to be a problem with capsular contracture that will be dealt with at the same time.

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.