What Could These Breast Implant Complications Be? (photo)

I am 2 mos. post op. my right breast when animated has crease that is less visible when relaxed. The breast tissue feels like its riding on top of the implant. The breast on the right when I lay down falls into my armpit while the right breast sits high on my chest, the left is flat on top and falls to the outside. I do not have pre op pics but I have silicon gel implants sub muscular and went from a 34B to 36D

Doctor Answers 4

Breast implant complications

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This is an extreme form of "double-bubble" deformity. Dr. Rand has it correct although the pec is not usually attached directly to the skin. 

The problem is caused by releasing the origins of the pectorals major muscle from the ribs behind the lower part of the breast in order to get under it but then not releasing it in the dual plane so it sometimes attaches to the breast tissue and connective tissue above (in front of) it. It is also aggravated by releasing the pectoralis muscle too high along the medial border of the breast. The result is that the lower end of the muscle contracts and pulls on the breast and tissues above it (which are ultimately attached to the skin) and causes this deformity which looks like an inframammary crease and is worse on flexion of the pec. It also creates the sensation of the breast tissue riding up. 

Correction involves a release of the pectoralis out of the lower pole of the breast but is hard to correct along the medial edge of the breast where a neo-pocket/capsule may be needed. As Dr. Lynam mentions, this is not within the knowledge/experience of some plastic surgeons, particularly if they don't understand the nature of the problem. 

Interestingly, this doesn't usually happen with subpectoral positioning of implants even without a dual-plane release. In this case it didn't seem to do it on the left side. It is not totally clear what all the factors are that determine it but the revision is pectorals release off the tissues of the lower section of the breast. 

Boulder Plastic Surgeon

Breast implant revision

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I agree with the diagnosis by Dr. Rand. This can be repaired and improved with revision surgery. The key is having a doctor who not only is able to diagnose your problem but has a definitive plan for correction. Unless these two things occur then the surgeon is unlikely to fix things and may make them worse! Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

What Could These Breast Implant Complications Be?

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Given that this is presumably a photo with pectoral flextion, it seems clear that you are looking at the lower edge of the pectoral muscle. It would be helpful to see how this looks at rest. I'm a little confused about the right and left descriptions about implant motion when you lie down, and here also photos will help. 

If the appearance at rest is barely noticeable, I would allow a few more months to pass before deciding about whether another operation may be needed. In the meantime, discuss with your surgeon any remedies that might help avert surgery-implant massage, massage at the site of the indentation.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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Reattached pec muscle

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It looks like your pec muscle was totally released from the lower inner corner and the muscle retracted up and reattached to the skin.  Now when to contracts it pulls the skin in.  This can be addressed by a surgical revision.

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