I have had implants for 2 years. Why do I have this indentation when I flex? (photos)

Doctor Answers 6

I have had implants for 2 years. Why do I have this indentation when I flex?

Thank you for your question.  This is an animation deformity caused by the contraction of the pectoralis muscle.  Unfortunately the only correction is reoperation with reconstruction using acellular dermal matrix to reattach the cut edge of the pectoralis to the chest wall.

Animation deformity

We call this in animation deformity as it  related to movement of the pectorlais muscle. Unfortunately, the only fix for this is to go back to the operating room and repair the deformity on the right side usually with some loosening of the muscle above and the suturing of a piece of an ADM such as Strattice to the edge of the muscle back down to the bottom of the pocket to prevent this muscle from pulling away. I would go back to your operating plastic surgeon to discuss your options. Best of luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Breast deformation with muscle flexion

Hi yodog

Wat you are seeing is a deformation of your breast due to the Pectoralis Major Muscle flexing and displacing the breast gland off of the implant. This happens occasionally when the is placed under the muscle, and is difficult to fix.  If it bothers you enough, it will require surgical correction.

Hope this helps.


Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews


Hello and thank you for posting photos along with your question. Sorry you are having issues with your breast augmentation. It would be helpful to know how the surgeon performed the operation. I am assuming he performed the operation about the same way on both sides but yet one side appears to have only minimal animation while the other side has much more animation and that dent you were talking about. This dent and animation of your breasts are occurring because of the chest muscle otherwise known as the pectoralis muscle. Evaluating a complex problem like this is not easy and only an in person evaluation can give most of the information needed to provide and appropriate diagnosis and surgical plan. However, based on the photos it appears as though your muscle may have separated a little too much from your sternum. Normally, the chest muscle is prevented from retracting like that because it still has some attachments to the very bottom of your breast bone (sternum). If this muscle separates from the sternum to high up then you can get this deformity. There are options on how to fix this but it all depends on the surgeon experience and how comfortable he/she is with fixing this issue. You should discuss your concerns with your plastic surgeon and make sure whoever your are being evaluated by is a board certified plastic surgeon. I hope this helps and I wish you the best of luck!

Ankur Mehta MD

Ankur Mehta, MD
Sugar Land Plastic Surgeon
5.0 out of 5 stars 17 reviews


You probably have developed some scar tissue that pulls on your muscle when you flex. This can be corrected with surgery. I would suggest going back to your surgeon and discussing your concerns.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Why do I have an indentation in my breast when I flex after a breast augmentation?

Thank you for your question.  What you appear to have developed is what is called an "animation deformity".  This is when breast implants are placed under the pectoral muscles and the surgeon does not divide/cut the edge of the pectoral muscle where it originates along your lower breast bone.  Cutting the edge of the muscle will prevent the pectoral muscle from deforming the implant when you flex your chest muscles.  Failure to do so (or failure to release enough of the muscle) will allow the deformity to occur.

I have seen animation deformities assume all kinds of shapes, so this is most likely your problem until proven otherwise considering it is happening only when you flex your chest muscles.  You need to be examined in person by a board certified Plastic Surgeon.  If you are happy with your Plastic Surgeon, you need to call him/her and go show them what has happened.  They should be willing to fix the problem.  If not, you may need to choose another surgeon.  If the problem really doesn't bother you, then you honestly don't have to do anything about it right now.  Best wishes!

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