Implants have not dropped and muscle flex deformity after 6 months. Will muscle release under local anesthesia fix it? (Photo)

Question

I had a breast augmentation on July 1, 2014 (6+ months ago). My implants have not dropped and I feel like I have more muscle flex deformity than normal. The tightness has been making me uncomfortable and often i'll wake up to burning muscle pain. My board certified plastic surgeon has suggested muscle release under local anesthesia now that six months have passed. I'm really concerned about having muscles cut under local. Will this be an effective solution to my issues? Is there an alternative?

Alex Campbell, MD · Answer

I agree that the implants are too high.  The implants should be directly behind the nipple areola complex so that this is on the most projecting part of the breast.  The technique that best achieves this is a Dual plane technique, where the implant is below the muscle in the superior pole of the breast, and the lower portion of the muscle is released to allow the implant to fill the lower pole of the breast.  I would not do this under local anesthesia.  This needs an operating room with full sterile technique as the implants should be removed to adequately dissect the pocket for more ideal implant placement.  Do it right and you can get great results.  Most important is a consultation with a Board Certified Plastic Surgeon regarding this procedure. Don’t settle for less!

Mark K. Markarian, MD, MSPH, FACS · Answer

Thank you for all the pictures.Pectoralis muscle release will help the implants drop and subsequently improve the overall shape of the breast as well as the relative position of the nipple & areola on the breast.Local anesthesia, however, may be difficult to tolerate as the muscle is operated upon.  Typically the muscle will contract significantly during the surgery, which at the very least, will be a disconcerting sensation...Good luck.Dr Markarian

Alejandro Nogueira, MD · Answer

You are a victim of the total submuscular location; in this technique 
the muscle fully covers the implant, therefore the implants can't be as 
low as they should, the breast remains empty and when you contract the 
pectoralis muscle the protheses move up and down, like a lift (elevator 
breast is called).I'd recommend renewal for implants of anatomical profile, and wider base to fit your ribcage, and either conversion to partial submuscular (dual plane) or fully subfascial (the most modern trends).You need a very good revision surgery surgeon, total anesthesia and full understanding of your issue from the professional.

Gary Lawton, MD, FACS · Answer

After 6 months there is very little that is going to happen with respect to the implants falling into position.  This may require a revision surgery to release the lower pole and the muscle.  I would do this under general.

Jeffrey Antimarino, MD, FACS · Answer

It appears your implants are too high because the lower edge of the muscle was not released enough to allow the implants to sit lower on your chest wall.   I agree that the muscle needs to be released but I would prefer to do that under general anesthesia or IV sedation at the least.

Paul Silverstein, MD (retired) · Answer

This is a common problem, and can be fixed by muscle release. Whether or not you should have it done under local anesthesia is another question, depending on your pain threshold.  Personally, I would recommend IV sedation rather than local anesthesia.

Implants have not dropped and muscle flex deformity after 6 months. Will muscle release under local anesthesia fix it? (Photo)

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