Are muscular women at a higher risk of animation deformation with submuscular implants? (Photo)

Question

Hi, I appreciate you taking the time to view this question. I have just had a second consultation with a different surgeon today about a breast augmentation. Unlike the first surgeon, who recommmended a dual plane approach, this surgeon said that I am at a high risk of animation deformity with submuscular, and that I should have the implants placed over the muscle. I am now very confused!

Azita Madjidi, MD, MS, FACS · Answer

I have performed dual plane since the technique was available and never went back to subglandular especially someone who is as thin as you are. You don't have enough fat under the skin to hide the top edge of the implant, the implant will only be held by your skin which is already so loose and  will sag quicker and the implant will be next to the breast gland, so higher risk of capsular contracture. 
The animation is very noticeable with submuscular plane not dual plane if it's done right.

Finny George, MD · Answer

Hi, thank you for sharing your question. Submuscular implant placement will always have some amount of animation deformity. This may be more pronounced in patients that are more active or muscular. Subglandular or subfascial placement is the only way to avoid it completely.

Leland Deane, MD, FACS · Answer

I don't think you're at higher risk. I routinely place submuscular implants in athletic women with great and natural results. The muscle is released selectively and only as needed and the implants are relatively small but appropriate. I'm happy to do a virtual consultation if you wish and can show you photos.

Joe Gryskiewicz, MD, FACS · Answer

Hello,
You may ask 10 doctors the same question but you may get 10 different answers. If you like to workout or have a labor intensive job I may suggest going on top of the muscle. There would be no muscle animation and less risk of implant displacement. 
All the best,
Dr. Joe

Daniel Barrett, MD · Answer

Dear Onelove79,
I almost always place implants submuscular. It lowers the rate of capsular contracture significantly. In addition, it looks much more natural because the muscle provides covering over the implant so its not as round on the top. I've also noticed the implants drop less over time when they are protected under the muscle.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jeffrey M. Darrow, MD · Answer

There can be more problems with animation if the implant is placed below your pectoral muscle.  It is far less likely above the muscle.  A dual plane approach for breast augmentation is still placing the implant below the muscle, although the muscle is partially divided.  With only a small amount of breast tissue, like you have, the animation of the implant would be more evident because there is less tissue to camouflage it.  You may wish to meet with additional plastic surgeons to get additional opinions as to which way would be the best way forward for you. Best wishes.

Kayla Humenansky, DO · Answer

I can see how that would be confusing. One of the joys of plastic surgery is there is not just one to do something, and neither is necessarily incorrect. Generally speaking, patients who flex their chest muscles (i.e. body builders or entertainers) animation deformity can be problematic. If that is not you, then it should not be a problem. You can have submuscular or dual plane placement with minimal movement of the implant; however, a submuscular implant will almost always move to some degree when flexing the chest muscles. For patients with limited upper pole or superior breast fullness, such as yourself, a pre pectoral implant may be more prominent and show rippling or visibility of the implant capsule. A dual plane approach allows the implant to fill out the lower portion of the breast tissue while providing superior pole coverage. I hope this helps!

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. A large portion of my practice is dedicated to breast surgery and revision breast surgery. You are an excellent candidate for a standard dual plane breast augmentation with silicone implants. I have a whole gallery of patient's I have long-term deformities associated with placing implants on top of the muscle.  There is virtually no support when you place the implants on top of the muscle, and they tend to slide down and have a much higher rate of capsular contracture.  An animation deformity is possible and probable in every body.  The vast majority are happy and the animation deformity is minimal. I also have a lot of experience in dealing with The builders as well as a figure and fitness competitors.  He should be able to have an excellent result.  Best wishes to you.

Gary M. Horndeski, MD · Answer

Yes, muscular women are at higher risk for animation deformity with submuscular implants. However, it may be possible to place your implants totally submuscular while using a circumareola approach to elevate the nipple-areola complex higher. You may be able to avoid the dual plane which extrudes inferiorly and laterally or use smaller size implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Most women are ok with this. The implants can temporarily "dance"  when the chest muscles are  tightened, much like wrestlers on tv. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Are muscular women at a higher risk of animation deformation with submuscular implants? (Photo)

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