I had a breast augmentation with saline implants 16 years ago. I noticed right away that when I did certain moves with my arms, my chest muscles could move my breast. I have always hated the feeling and did not like the way it looked when it happened. I just went in to exchange my saline implants for silicone. My doctor cut some of the chest muscle and told me it should help some. It was better,but its now doing the same as before. The bottom of my breast as well. Can this be stopped?
Can Flexing of Breast Muscles Be Stopped?
Doctor Answers 4
Implants under the muscle will move with muscle contraction. Ideally the motion should be mild or minimal so there is little distortion of the breast. The way to prevent significant movement or distortion with muscle contraction is to release the inferior insertions of the pectoralis into the chest wall and release the muscle fibers insertion into the underside of the breast at the time of surgery. Unfortunately, after all that, the implants can still move some when the muscles are strongly contracted. Converting the implants to over the muscle certainly can correct the muscle distortion but also will make them more prone to capsular contraction (hardening of the implants) Make them more prone to sagging and easier to feel and see rippling so the decission to convert them souldn't be made lightly. Careful examination could determine if they can still be corrected keeping them under the muscle still. If you have a generous amount of breast tissue maybe the solution could be to put them over the muscle using texturized implants (the ones with the fuzzy surface) which seems to delay the presentation of capsular contraction.
Implant motion with chest flexion
If your implants are placed in a pocket below the pectoralis major muscle, muscle flexion will produce a deformity. For most patients this is acceptable for the benefits this procedure produces. Cutting the muscle more may not improve the situation because the scar tissue that covers the implant will bridge the cut in the muscle and not completely correct the issue. Your only alternative would be to place the implants on top of the muscle.
Implant movement with flexing
This is one of the down sides of submuscular implants, that the implants can move funny with flexion. The only alternative tis to place them subglandular.
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Breast implant revision
Muscle distortion is difficult to completely eliminate with revisionary surgery unless the implants are replaced in the sub glandular position. However, because of the significant disadvantages associated with implants in the sub glandular position, I would recommend revising your current breast implant pockets (with further release of the pectoralis muscle attachments medially and inferiorly. This revision, of course carries its own risks such as medial or inferior implant malposition (bottoming out).
Please make sure you're working with a well experienced board certified plastic surgeon.