I am considering having my implants moved above my pectoral muscle. Any suggestions? (photos)
Doctor Answers 9
Submuscular breast augmentation.
Even at rest your lower pole contour does not look smooth and rounded. This could be a sign that your implant is either bottomed out or that you had a component of breast constriction prior to surgery that was not corrected at the time of your operation.
Moving the implants
Implants below the muscle
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Dr. Sheila Nazarian
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Breast distortion following breast augmentation
Breast Implant Revision
I can understand your concern regarding the animation deformity, it looks quite significant in your case. As you suggest, a way to treat this is to move the implant above the muscle. I recommend you discuss this with your original doctor. If your original doctor does not provide the answers you desire, or does not have extensive experience with revision breast surgery, I recommend getting a second opinion from another plastic surgeon. Best of luck!
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Choose the surgeon and not the procedure.
Distortion possibly from incomplete release of the inferior medial pectoralis muscle
Thank you for the photos and question. A detailed physical examination and review of the original surgeon's operative report would contribute greatly to a new consultant's opinion. Nevertheless, your photos are excellent and demonstrate 1) inferior areolar incisions suggesting transareolar implant access. 2) soft tissue tightness at the lower inner breast pole has caused medial flattening of the breast. 3) active flexion of muscle displaces the implant laterally and further accentuates the deformity, suggesting the tissue tightnesses were consequences of incompletely divided inferior medial pectoralis muscles.
Most surgeons who place implants in a "submuscular" position intentionally divide the inferior medial pectoralis muscle. Division permits a submuscularly placed implant to descend and form the rounded gentle feminine curves of the lower inner breast. When this muscle is incompletely divided, the lower inner breast is pressed flat even when the muscle is relaxed. Active contraction of an incompletely released muscle further accentuates the deformity by displacing the implant outward.
This can be addressed in several ways. If your soft tissues are robust, implant site change to a subglandular position would be an effective method of correction, albeit with a minor increase in capsular contracture risk. Alternatively, reoperation with division of the residual inferior medial pectoralis muscle can also be effective and is a preferred alternative when breast tissues are too thin for subglandular implant repositioning.
Consultation with an experienced reputable plastic surgeon will enhance the diagnostic accuracy of the problem and permit a proper discussion of treatment options/risks/benefits.