Will a dual plane augmentation help to correct animation? (photos)

Question

I currently have 320cc uhp silicone under the muscle implants. It has been 1 year since surgery with a lift. I have lots of muscle animation and I love to work out in the gym and it seems to be getting worse. I want to change the shape to a lower profile and am wondering if I should go subglandular or dual-plane. I know subglandular is not ideal but will dual-plane help muscle animation. My surgeon mentioned both options.

Richard Baxter, MD · Answer

There appears to be a lot of confusion about the causes of animation deformity; the dual plane procedure, because it detaches a portion of the muscle which then adheres to the capsule, is a cause of animation not a solution. The alternative is the split muscle procedure, which is quite different. You are very thin so going over the muscle will not be ideal. There are several articles, before & after pictures, and other resources about animation deformity and the split muscle technique on my website.

Shlomo Widder, MD · Answer

Dear famof6,  First of all, congratulation on your large family and thanks for submitting your pictures. From observing your pictures the following is noticed:  1. Wide cleavage.  2. Severe capsule contracture.  3. Implants riding high, possibly due to intact muscles at the lower pole.  4. Mild ptosis.  Well, regardless of the nomenclature,  the solution to your problem is capsulotomy (scar release) with possible muscle release at the IMF ( infra mammary fold ) and lowering of the IMF. Meticulous  dissection medially for creation of nice cleavage and and mini lift ( donut ) for more attractive positioning of the nipples.   I would not place the implants sub glandular. In my opinion, it will be a mistake that you will regret for many reasons.  Consult with experienced board certified plastic surgeons who do lots of 'redo' breasts augmentation in accredited surgery center for your safety. Check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage and nice slope.                        Best of luck,                                             Dr Widder

Jeffrey D. Wagner, MD · Answer

I would recommend you consider switching to a sub glandular implant pocket with a silicone gel implant.  You are muscular and your lifestyle is really not going to be a trouble-free fit for sub muscular implants, even dual plane.

Steven Wallach, MD · Answer

You are between a rock and a hard place. Dual plane is under the muscle and animation issues still will be present. Sub glandular should resolve the issue  but may cause noticeable rippling with a thin envelope.

Ciro Adamo, PhD, MD · Answer

Dual plane would not solve the problem of breast animation, as technically the implants are still, at least in part, under the muscle. Moving the implants in subglandular pockets would work, and you should be able to achieve a good result with cohesive gel implants and a conservative size/profile.

Kent V. Hasen, MD · Answer

Thank you for your question.  I assume that the frontal photo is showing you flexing your pectoralis muscle and creating the animation deformity.  If not I would be concerned that the right implant was too high from a possible capsular contracture.  You are very thin and without much natural breast tissue.  Additionally, you have a lot of muscle.  The implant being under the muscle will lead to a lot of motion when it is activated, especially if you continue to build it up.  The only way to completely stop the animation deformity would be to move the implant to the subglandular or subfascial plane.  If you do this you will run more risk of capsular contracture and visible edges.  This can be minimized by the use of the textured shaped silicone gel implants like the Allergan 410 cohesive gel implants.In short, there is no perfect option, so you will have to decide which is the best for your situation.

Will a dual plane augmentation help to correct animation? (photos)

Answers (6)

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