Can Under the Muscle Implants Be Moved to Over?

Yes you can move breast implants from under the muscle to over the muscle or vice versa. You have two options to correct the deformity you describe:

1. You can change the position of the implants from under the muscle to over the muscle. This would correct the animation deformity you have with muscle contraction. The downside is that the entire weight of the implant would be placed on the breast gland and skin, which can cause thinning of your breast tissue and accelerate the effect of gravity. In addition, you would increase the risk of implant visibility and rippling.

2. The second option to to use regenerative medicine to reinsert the moving muscle. An acellular dermal matrix like Strattice would allow you to keep the breast implants under the muscle and reduce or correct the animation deformity you see with muscle contraction.

I would say that there is a good chance that the muscle was inadequately released at the first surgery, and that remove replace with cutting of the capsule and releasing the muscle will improve your outcome.  switching the implant position is not the answer.

The simple answer is yes the
implants can be moved over the muscle. The most common reason to move the
implants above the muscle is in active patients that develop an “animation”
deformity. An animation deformity is
when the implant and breast are moved when the pectorals muscle is flexed. Typically it will cause a crease across the
breast as the muscle is flexed.


Like anything in life there are pro and cons to
moving the implant over the muscle. Typically the implants are placed under the
muscle to keep the breasts soft and natural. If you move the implant over the
muscle you have to do several things to keep the breast looking natural and
soft. Any time you place the implant over the muscle you will feel more of the implant,
as the muscle is no longer present to cover the implant. You also typically
need to use a textured implant when the implant is placed above the muscle to
prevent excessive scar tissue from forming around the implants. Silicone implants have made placement of the
implant above the muscle more reasonable as they are much softer and natural
appearing than saline implants were previously.
In the past a saline implant placed above the muscle would be very firm,
this is not necessarily true for the new silicone breast implants.



Patients with the correct
operation can achieve a very attractive breast and avoid the animation
deformity with an implant placed above the muscle.

This surgery is possible and occasionally needs
to be done in very active woman. I would just make sure that you discuss the
surgery with a board certified plastic surgeon that can discuss the risks and
benefits of the surgery with you.

As can be seen, you have a very good results at rest and when you move the animation can be seen. If it remains painful, you can consider moving the implants to above the muscle. Based on the amount of breast tissue you have you van discuss with your surgeon if you will benefit from any mesh. Generally secondary operations do have their own risks and complications

Thank you for sharing your question and photos.   Your issue, dynamic breast implants, is not uncommon.   The simplest and most reliable solution is to do just what you are asking about - moving the implant to a subglandular plane.     Based on your photographs, it looks like this would be a reasonable solution for you, but of course, you need to be examined by a plastic surgeon to discuss the risks and benefits.    

YES!! You sound like a perfect candidate for a subfascial conversion assuming you have sufficient soft tissue coverage to camouflage the implants. Generally speaking, if you have at least 2cm of "pinch" in the upper pole of the breast, you would potentially be a great candidate for such conversion. You have hyperanimation which is a fairly common event following submuscular implant placement. Even with the addition of ADM in the lower pole, if you keep your implants in the dual-plane position, they are subject to the animation forces of the pec muscle and you will still have that classic unsightly contracture which can also be uncomfortable. This is a fairly routine procedure whereby in addition to the subfascial conversion, a piece of mesh is utilized to stabilize the implant, minimize rippling, and provide a long lasting result. Some patients who are thin may require secondary fat grafting if there is any associated rippling. Talk to your board-cerftified plastic surgeon about this.