Breast Deformity from Muscle Pulling in from Peri-areolar Incision?

I have a peri-areolar incision from breast augmentation which pulls inward, and even more when flexing the pectural muscle. Even at a resting state one breast looks distorted. Is there any way to fix this?

Doctor Answers 5

Submuscular implants can create the "motion deformity" with pectoralis muscle flexion

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Breast implants can be placed in one of two locations:  above the muscle, known as "subglandular", or below the muscle, known as "submuscular" or "subpectoral". 

The pectoralis major muscle was designed with a flat surface and a straight line of pull.  When it is stretched out over a breast implant, it can cause flattening of the breast, pulling upwards and outwards of the implant, and wrinkling or pulling of the skin when the muscle is flexed.  This is known as the "motion deformity"

To alleviate this effect of having a submuscular implant, the "plane" (space) of the implant can be changed from under the muscle to on top of the muscle.  Conversion of submuscular implants to the subglandular position requires a surgical procedure with some downtime and the placement of drains.  However, the motion deformity will be gone and the breast will likely assume a more natural look and feel, regardless of muscle flexion.

Karen M. Horton, M.D., M.Sc., F.A.C.S., F.R.C.S.C.

San Francisco Plastic Surgeon

Correction of Breast Deformity

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You did not say how long ago you had your surgery.  I think this is important.  If your surgery was recent, within the last few months, then the problem may get better.  Massage of the area to help break up the attachment of the muscle to the overlying tissue might help.  If its been a long time since your procedure then surgery may be indicated.  Its important to understand that some distortion of your breast appearance when flexing is normal after subpectoral placement but a deformity in the restng position may require surgery.  Unfortunately,  new scar tissue will form from the new surgery so this is not foolproof.  There has been use of acellular dermal matrix (a product harvested from pig skin) that helps to break up the connection from the muscle to the overlying skin although I do not have experience with this.  Talk to your plastic surgeon to get a better assessment of your situation and your options.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

Distortion of the Areola from peri-areola Augmentation incision, can it be Fixed?`

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The answer is yes, a simple scar revision can fix the apppearance of your scar and release it from underlying attachments, but the problem of the animation deformity or increase in distortion with flexing of the chest muscles is more complex, I would encourage you to visit with your original surgeon and discuss your complaints and goals. 

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

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Breast issues with sub pectoral implants

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The pulling of your periareola scar can be possibly create with scar revision.AS for the animation deformity, this happens with sub muscular implants sometimes.  To correct this, sometimes moving them in a subglandular pocket can help.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Muscle pulling deformities, aka motion artifact deformities, following breast augmentation are correctable.

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I'm sorry you're having this problem. Unfortunately, you are not alone. This is a well know problem related to sub-muscular breast augmentation surgery. This happens because the scar tissue from your original surgery connects your incision with the lower edge of your pectoralis muscle, resulting in the type of deformity you describe. The muscle needs to be released from the scar tissue so that it no longer tugs on your nipple. The capsule around the implant may either be involved or you may have a capsular contracture. How your plastic surgeon approaches this problem and the extent of this surgery depends on the shape and severity of the problem, as well as the appearance of the peri-areolar incision. 

Perry Liu, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 5 reviews

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.