Is this Lateral Displacement & Muscle Flex Deformity? 1 year post-op. Saw PS today, but he said I have good results (Photo)

My PS said they are supposed to fall to the sides & the muscle flex is to be expected under the muscle. I'm 5'6", 105 lbs. Mentor Smooth silicone 325cc HP. I showed him that I can move the implants around an inch left & right & about 2" up. He said that's normal, but I think pockets are too big. Told him Sientra True Texture is designed to maintain implant position. He said there's no guarantee that those won't fall to the sides. Asked to go a little wider & taller, but he said not a good idea.

Doctor Answers 10

Implant position

The implants are placed too laterally. This is difficult but can be corrected with surgery. This movement of the breast with muscle activity is sometimes referred to as "motion artifact". Low-body-fat women with a very active lifestyle are at most risk of dissatisfaction, although one recent study showed that 100% of women with subpectoral placement were concerned with this movement of the implants. I agree that the textured implants are less like to shift their position. The best solution was developed almost 20 years ago by a Professor at Sao Paulo University (Ruth Graff) called "subfascial" placement. This is the a very common placement in Brazil but infrequently done in the US probably because it's difficult to learn. This position places the implant under the outer covering of the muscle (giving the extra protection for wrinkling or exposed edges) but avoids the motion artifact.

Frederick Plastic Surgeon
4.1 out of 5 stars 12 reviews

You do have a lateral displacement

you have implants that have a diameter that is probably too narrow for your frame and you do have animation deformity.  I would suggest getting wide (larger diameter) implants, closing off the lateral breast space, and releasing the muscle to minimize the animation deformity.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 415 reviews

Is this Lateral Displacement & Muscle Flex Deformity? 1 year post-op. Saw PS today, but he said I have good results

Yes your diagnose is correct. But could revision surgery improve the results is the question. Very hard to advise via the internet... 

Is this Lateral Displacement & Muscle Flex Deformity? 1 year post-op. Saw PS today, but he said I have good results

I agree that in particular your right breast implant is laterally displaced.  This can be revised however extreme caution must be used to make sure that closing the lateral or outside pocket does not cause the nipple areola 2. towards the outside.  I do not think placing the implants beneath the chest muscle is wrong but I do think the pockets are probably too large and too laterally displaced.For more information on revision of breast augmentation please read the following link:

Correcting breast implants that move with muscle contraction

This is a very common problem in women who have had implants placed under the muscles.  Contraction during daily activities and especially exercise can be concerning.  In this case, I usually recommend removing the implants, suturing the muscles back down to the chest, and then replacing the implants over the muscle.  This has worked well in a number of patients.  The recovery is only a few days with minimal discomfort.

Thanks for your question!

Dr. Schreiber, Baltimore plastic surgeon

Very thin with implants

You are very thin, and the implants tend to be more prominent in appearance.  Some lateral displacement can occur and under the muscle implants can produce the effect shown.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Is this Lateral Displacement & Muscle Flex Deformity?

While this is not a substitute for an examination it appears you have a little of both.  I don't know what your pre-op expectations or desires were so this puts me at a disadvantage.  I does appear that the muscle has reattached and that the pocket may have enlarged laterally over the year.  You have a very low percentage of body fat which I have found gives more of an artificial appearance especially when using high profile implant.  The treatment is usually exchange to a less projecting moderate profile plus implant and adding Seri mesh or alloderm to cover the implant.   Good luck with whatever you decide to do, Dr. Schuster in Boca Raton.

Breast augmentation revision

Your plastic surgeon thinks this is a good result? Clearly you do not. If you feel like your plastic surgeon is not listening to your concerns you may want to consider finding another plastic surgeon.

I use a lot of Sientra breast implants. I have also used Mentor and natrelle(allergan implants. They each have a role. One significant difference is that Sientra will not seek breast implants to anyone other than board certified plastic surgeons. If the doctor who performed your surgery is not a board certified plastic surgeon he may not have access to these implants.

You situation can be improved. But, you will need a plastic surgeon with expertise in breast augmenattion revision. View many, many before and after images and take your time finding a surgeon. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 113 reviews

Breast Implant Placement

Breast implants fall where there is room. If a patient has breasts that naturally angle toward the sides, then that's where the implants will end up, whether they are smooth or textured. Patients with more centrally facing breasts can expect their implants to be more central (see link below). Implants with a wider diameter could extend to the sides even more.

Placing implants under the muscle has some advantages, such as a slightly lower capsular contracture rate and ease of displacing breast tissue during mammograms. However, when the muscles contract, they can move and change the shape of the implants temporarily until the muscles relax.

You can always seek a second opinion. If you do, you should choose a board-certified plastic surgeon with good before-and-after photos. 

Heather J. Furnas, MD
Santa Rosa Plastic Surgeon
4.8 out of 5 stars 28 reviews

Implant displacement

The cause for lateral displacement may be: 1) Anatomy ("Pigeon chest". Implants can slide laterally if the chest has an  inverted v shape or if the breasts are widely space)   2) Pocket much larger than implant  3) Inadequate release of the muscle ( generally the lower portion of the implant is not covered by muscle).   Muscle contraction will lift and laterally displace the implant.   4) Smooth shelled implants (in particular saline implants).  Textured implants allow tissue ingrowth  to maintain position.  Most women prefer full medial cleavage.  This may not be possible in slim women.  The pocket should not be dissected closer than 1.5 cm from the midline of the chest.  Closer than this could lift the skin off the breast bone producing a web between the breasts.  If there is insufficient soft tissue coverage you will see and feel the implant.  

Robert Sleightholm, MD
Brampton Plastic Surgeon
5.0 out of 5 stars 9 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.