Im 5'3" and wear a C/D cup. Everything looks natural until I go to gym and lift ANY weight or pull myself up out of the pool- then I notice both implants up under my collar bones. VERY EMBARRASSING!!!!! I got 2 plastic surgeon consults. One recommended just changing implant to a "smooth" one-assuming the current one had texture (dont know). The other recommended suturing the muscle down w new implants. Recommendations? Thank You, E
Breast Implants Rise Up when I Contract Pecs. When I Relax They Slide Back Down?
Doctor Answers 11
Submuscular breast implants
What you are describing is normal with implants under the muscle. When you flex your pectoralis (chest) muscle, it pushes the implants up, out of normal position. When you relax the implants return to their normal place. This action reduces the risk of capsular contracture. The only solution is to place the implants on top of the muscle. The disadvantage is that the implants will be more visible and palpable. I would highly recommend silicone implants if you are considering switching to sub-glandular placement.
Extreme Animation Deformity With Submuscular Breast Implants
Some animation deformity is common with submuscular breast implants but yours does sound excessive. You have several options. Releasing the lower attachments of the pectoralis muscle, particularly if this was never initially done, may help cut down the upward muscle pull. The other option would be to switch the implants into a subglandular pocket. Which one of these would be better would depend on what type of implants you have now and what your breast anatomy is. (little or some breast tissue)
Movement of implants after breast augmentation
Placement of implants in the submuscular position will lead to some motion whenever the muscles do contract. That is both the advantage and disadvantage of submuscular placement. This motion theoretically helps decreases capsular contracture. The disadvantage is what you are describing. Your motion does sound a bit excessive. A simple fix would be to switch the location of the implants to above the muscle. If this is done, there is a much higher risk of visibility of the implants depending on the amount of breast tissue that is already present. Good luck!
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Distortion with subpectoral augmentation
If you are very concerned about the movement of the implant when you contract the muscle the proper decision would be to convert your augmentation to a submammary, above the muscle, augmentation. This will prevent the distortion to the breast implant location when the muscle is contracted. There will not be any elevation to the implant with contracture..
I have done this many times with my patients over the years if this problem exists. Nothing else will guarantee that you don't have some continued distortion.
Talk this over with your Plastic Surgeon, and don't hesitate to get several opinions.
Good luck to you.
Frank Rieger M.D. Board certified Plastic Surgeon in Tampa
Changing to smooth implants (or to textured for that matter) will not help your problem. Some times the bottom part of the pectoralis muscle separates too much from the sternum leading to this "hyperdynamic deformity". Although sometimes difficult, improvement can occasionally be gained by reattaching some muscle in this area. Over the muscle would correct this completely but you need to thoroughly discuss the pros and cons of implant placement with your PS.
Implant animation in the subpectoral position
Some of what you describe is normal, but the degree of animation sounds excessive. It sounds as if the upper portion of the pocket may be over-dissected because normal animation does not usually cause movement all the way to the clavicle. It could be that the pectoralis major muscle attachments to the lower portion of the sternum may have been under-dissected. Adequate release of these muscle attachments can significantly reduce the amount of animation seen with pectoralis muscle flexion. While it is true that changing the implant position to a subglandular position will solve your current problem, it will also put you at risk for several other issues (palpability, increased risk of capsular contracture, thinning of your native breast parenchyma and dermis, "bottoming out" of the implants, and (in my opinion) just having an unnatural appearance to the breast. I would suggest another consultation with a board certified plastic surgeon who frequently uses a dual plane approach to implant positioning. Conservative release of the medial attachments of the pectoralis muscle and allowing the muscle to slightly "window shade" superiorly may eliminate much of your problems. You may also need to close the upper portion of the pocket with a suturing technique to prevent the upward displacement of the implants. Although this approach would be more intensive than just changing the implants to the subglandular position, I think that it would give you the best long term results.
Animation deformity from the pectoralis muscle covering the implant
It sounds like your implants have been placed under the pectoralis muscle on your chest. With a subpectoral implant position, flexion of the muscle will almost always cause some distortion of the implant, just as you have described. The most successful way to fix this problem is to change the implant to a subglandular (above the muscle) position. There are certain considerations for this change in position, namely, the thickness of your soft tissues, and what type of implant you want to have as silicone implants perform much better in the subglandular position than do saline implants. These detailed facors cannot be determined without an in-person consultation. A board certified plastic surgeon in your area should be able to discuss the pros and cons of changing your implant position with you.
Breast animation: placing the implant on top of the muscle will fix the problem
Thank you for the question. Implant type and attempts at suturing the capsule or muscle may improve the degree of breast animation you have but it will not fully repair the process and it will often only do so temporarily. The only full, permanent correction is to place the implant on top of the muscle. If you are a candidate for this it is an easy fix and an easy recovery.
All the best,
Dr Remus Repta
Animation deformity after implants
Sometimes an animation deformity can develop after submuscular implant placement. One possible solution is to change the pocket position but if you are very thin, then you may see rippling. A split muscle technique may help.
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.