125lb, 5’4”. Changing implants from 290cc to 190cc. Will this equal less animation deformity and less palpable implants?

Question

Got dual plane, silicone implants 5 months ago. And will I have loose skin?

Eugene Kim, MD · Answer

A smaller implant will make it less palpable but it won't change animation deformity.  The deformity is caused by the implant position, being under the muscle.  The photo may be distorted but it looks like one of your breasts may be higher than the other so make sure you see a plastic surgeon to make sure you don't need any other revisions like a capsulectomy.

Anita Patel, MD, FACS · Answer

Some degree of animation deformity is normal with submuscular or dual plane breast augmentation. Downsizing the implant won't get rid of the animation deformity entirely, but if and how much it would look less apparent is tough to say, especially without an exam and seeing the degree of deformity you have. Decreasing the size may make you feel like the skin is loose initially, but over time the skin envelope will shrink around the newer smaller size, so I would not expect that to be a problem given your preop photos and the fact that you did not go with a huge implant to begin with (which would have stretched your skin even more). It also looks like  you may have an early capsule on one side in the photo, though photos can be distorted so again, an exam would be necessary to advise on that. If the animation truly bothers you, you could switch to a subglandular or subfascial location for the implant, although this would make the implants more palpable in general, since less tissue is between the implant and the skin. How palpable the implants are depends on how much breast tissue you have and how big the implant is. The larger the implant the more you will feel it, and the less of your own breast tissue you have, the more you will feel the implant (of any size).

Urmen Desai, MD, MPH, FACS · Answer

Downsizing by 100 will not change the animation deformity, as this is due to the plane that the implants are placed in.  Also, you will likely still feel the implants.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Richard Baxter, MD · Answer

Animation deformity is related to the detachment of the muscle that is done with the dual plane procedure. It can be corrected by converting to the split muscle plane, which will maintain muscle coverage over the upper part of the implant. You would lose coverage in the middle, but usually it is on the sides and bottom where the implants are palpable. Another thing to consider would be to change to a more cohesive implant such as Sientra or Allergan Soft Touch. Downsizing may result in a more deflated look with looser skin.

Tim Sayed, MD, MBA, FACS · Answer

I don't like the term "animation deformity" because the reality is that it is a phenomenon that is logically anticipated as a consequence of lifting the muscle. The dual plane approach usually means the upper part of the implant is covered by the muscle but the lower part hangs into the lower portion of the breast curvature for a more natural and softer result. However, if you feel your size is too large, reducing somewhat may help you feel more comfortable with the overall appearance. Fixing the animation issue often requires switching to a subglandular position, which carries a higher risk of capsular contracture. If you have enough tissue to cover in a fully subglandular position, that might be a consideration worth discussing with a surgeon. The tradeoff is basically between palpability/rippling/coverage concerns vs. animation phenomenon.As others have stated, at least one of your pictures looks like one breast pocket may be slightly higher than the other which may be indicative of a capsular contracture and you should discuss this with the surgeon(s) with whom you consult in order to examine this thoroughly and address whether a capsule procedure (capsulectomy typically) is necessary.

David A. Sieber, MD, FACS · Answer

Thanks for the great question. Placing a smaller implant will help some with implant palpability, but will not improve your animation deformity. Based on your photos, it looks like your implants are too close to the center and that they aren't sitting underneath you nipples. In order to not have an animation deformity, the implants need to be placed above the muscle. By doing this however, the implants will be even more visible. If you are very bothered by the animation deformity, you are a good candidate to have the implants moved above the muscle and then have some fat grafting around the implant to make it less visible. I hope this helps.Best,~Dr. Sieber

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and question but an examination is really needed to give an accurate answer what might be the best solution for you.  That said an animation deformity occurs when implants are submuscular so moving to a smaller implant may not change the problemDr Corbin

125lb, 5’4”. Changing implants from 290cc to 190cc. Will this equal less animation deformity and less palpable implants?

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