You are an excellent candidate for my making a neopocket for the implant which, in effect, is almost like starting over.
Thank you for your difficult question. unfortunately, implant animation can be an issue when placing them below the muscle; but there are a couple of things that I believe help reduce this risk and alleviate your current issue. Options and possible solutions:1) create a double plane pocket2) ensure the inferior/medial part of the pectoral is muscle is released to diminish force vectors directly on the implant itself 3) it appears you may have some migration of the implant downward so pocket integrity to ensure the implant is supposed to stay in the appropriate position is also critical 4) an internal support sling like strattice could also be of benefit for support and layering. I hope this may be of help. Return to your PS and see what options are available and the treatment plan that both of you can embrace. May your difficulties have a speedy resolution.
With the dual plane technique that is commonly used for implants under the muscle, a portion of the muscle is cut and it then heals into the scar capsule where it pulls. That also causes the double bubble that you see. It can be corrected by placing the implants above the muscle, making sure that the muscle is re-attached, or better yet convert to the split muscle technique so you have better coverage over the upper breast. There are several examples on my website and articles explaining the technique.
Unfortunately, this is a common problem I see in patients that have augmentation with the implants under the muscle. This can be corrected by removing the implants from under the muscle, reconstructing the muscle back down to the chest wall where it belongs, and reaugmenting the breast with an implant ABOVE the muscle.
I am sorry to hear about your concerns after breast augmentation surgery.
It looks like you have "double bubble" and breast implant bottoming appearance after breast augmentation surgery. A "double bubble" is a cosmetically undesirable circumstance for patients with breast implants, which occurs when the breast fails to take on the shape of the implant, resulting in the appearance of a visible line showing a separation between the bottom edge of the implant and the bottom edge of the natural breast. Double bubble "deformities" may be more striking (visible) when breast implants have bottomed out. The deformity becomes more striking with pectorals muscle flexion.
There are several options when it comes to revisionary surgery to improve your outcome. One option is to eliminate the pull of the pectorals major muscle either by completely releasing it or by suturing the muscle back down, thereby placing the breast implants in the sub glandular position. Patients who choose to have breast implants placed in the sub glandular position should have enough breast tissue coverage to allow for this conversion. There are disadvantages of placing breast implants in the sub glandular position (such as increased risk of breast implant encapsulation) which should be considered as you make your decisions.
Another maneuver that may be helpful is raising the inframammary fold using capsulorraphy techniques. In my practice, this type of repair involves a two layer, permanent suture repair (reconstructing the inframammary fold areas). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Radial incisions along the lower breast poles might help to reduce the deformity as well. Associated issues with positioning of nipple/areola complexes should improve with this operation. Sometimes, depending on the patient's anatomy, breast lifting may also be necessary. In other words, once the "foundation" (correct breast implant position on the patient's chest wall) has been established, the overlying breast tissue and nipple/areola complexes may need to be adjusted (usually moved superiorly) as well.
Sometimes, depending on factors such as quality of skin along the lower breast poles, additional support provided by acellular dermal matrix or biosynthetic mesh may be very helpful. I have also found the use of acellular dermal matrix very helpful in cases where the skin/tissues are very thin and in cases of recurrent breast implant displacement. The acellular dermal matrix helps improve contour, improves irregularities caused by the underlying breast implant and/or scar tissue, and provides additional support ("sling" effect) for the breast implants.
I hope this, and the attached link, helps.
risks come with it and you now are bothered by the animation. If you wish to eliminate the animation, you could change the implant position to over the muscle and repair the muscle that was released (this is important). If you are bothered by the double bubble, this will take more thought into resolving this. Best to see your surgeon for options from which you can choose and you can always repost the recommendations and see what the gallery supports the most.
You have several issues with your breast augmentation results. These problems are due to several factors. It appears that the implants are probably too large for your frame. The use of excessively large implants can result in bottoming out and double bubble deformities. Muscle flexion deformities or animation deformity can occur when implants are placed under the muscles. This can be eliminated if you have the implants placed above the muscle. However, I would only recommend this if you have have plenty of breast tissue to cover the implants. Another technique is to use a dual plane split muscle pocket. With this type of pocket you will still have some muscle flexion at the upper half of the breasts. Finally, it appears that you may benefit from a breast lift to improve the position of your nipples and areolae. Thank you for sharing your photos and concerns. Best wishes. Dr. Gregory Park, San Diego Plastic Surgeon.
Thank you for the photos and the question and YES your problem of flexion deformity and bottoming out can be corrected. So go on some complimentary consultaqtions with expertrs in your area and become informed how.