Why Does my Breast Look Deformed when I Flex the Muscle?

Your problem is unfortunately common and preventable. It is caused by the release of the pectoral muscle attachment from the ribs, which is routine but the edge of the muscle then heals into the scar capsule. When you flex you can see exactly where the muscle is pulling up. The groove across the breast, where the myuscle is attached, then creates the double bubble. The simplest method to correct it is conversion to a split muscle technique. There are photos on my website illustrating how this is done. If there is inadequate coverage and support of the implant, then a Strattice internal bra procedure would be better. I would be happy to send you some information about the procedure.

When the muscle pulls across the implant, the appearance may be affected. This can appear worse with more muscle #density and the #muscular strength. There are options to enhance this though. One is to change the implant to the submammary position. Another is to cut the muscle more along the sternum for the implant to reside.

You have fairly obvious double bubble due to muscular distortion of the breast shape due to hypertrophic chest musculature.  The edge of the muscle heals into the scar capsule and creates this deformity. In selected patients, sub glandular pockets are an excellent option and will provide a more natural cleavage and movement of the breast. This approach requires that you have enough tissue coverage and is easier to do with silicone gel implants than saline. You should be aware that it will be somewhat more difficult to obtain mammograms and you may be at somewhat higher risk of having capsular contractures with sub glandular implant pockets, however.

This is a serious problem that will require a complete revision. Open capsulectomies, inferior capsular sling to elevate the inframammary fold, and a full formal breast lift or mastopexy.

                  Based
on your pictures, it appears that you have breast implant animation deformity.
This condition usually results from dividing the perctoralis muscles during
creation of the breast pocket. The muscle then becomes adherent to the
surrounding tissue and with muscle contraction causes distortion of the
overlying breast tissue.

                  Although
the condition can occasionally be treated by repair of the muscles, the
majority of patients are treated by relocating the breast implants to a
sub-glandular position. This decision should be considered carefully because
the majority of patients are happy with their breast when they’re not
exercising.

                  It’s
important to realize that moving implants to a position on top of the muscles
involves a series of tradeoffs. Sub glandular implant relocation can be a
technically difficult procedure with the potential for complications. In
addition, patients give up the advantage of sub muscular placement of breast
implants. For instance, when breast implants are on top of the muscle,
mammography may be less effective and there is an increased rate of capsular
contracture.

                  Before
proceeding with any type of surgical correction, it’s important that you
understand these tradeoffs. Make sure you discuss these issues with your
surgeon before proceeding with surgical correction. 

Breast implants placed under the muscle may alter their shape when the muscle is utilized.  One of the risks of sub muscular breast augmentation is implant distortion with use of the pectoral muscle.  To help with your problem, there are a few options. The lower origin of the pectoral muscle can be released to help limit distortion.  If you have a textured implant, changing to a smooth surface implant will help.  Both of these options are relatively simple.  The surgery can become more complex if the lower aspect of the pocket needs to be closed down. I would discuss these issues with your Board Certified Plastic Surgeon.