Deadlifts and lateral displacement? Is revision urgent?

Question

Hi, I am a couple of years post op. Silicone textured unders, but had very little existing breast tissue and am very active. My PS mentioned nothing about lateral displacement but I am realizing now I’m predisposed to it and am 99% sure I have some to a degree. (Implants fall very far sideways when I am laying down). Now I am hyper aware of keeping them in place. 1) Is revision urgent, and 2) is deadlift harmful? That’s the only move I do that I’m afraid involves the chest too much. Thank you!

Richard Baxter, MD · Answer

Activity of the pectoral muscle pushes implants to the side, and if they noticeably move to the side when you lie down then the texture is not holding them in place. Closure of the capsule (capsulorrhaphy) is not strong enough to withstand the muscle so something else is needed. Consider converting to the split muscle plane and adding an internal bra material such as Galaflex. This will maintain some upper pole coverage, lessen the lateral push of the muscle on the implants, restore muscle function by re-attaching the lower part behind the implant, and add support on the sides for more stable implant position.

Connie Hiers, MD, FACS · Answer

No, you don't have to have urgent surgery. Your pockets could be tightened to minimize lateral movement. Being behind the muscle will always try to push the implants laterally with chest movement. I would suggest meeting with a board certified plastic surgeon and discussing your options.

Jeffrey W. Hall, MD · Answer

Textured implants tend to stay where you place them due to their adherent to the surrounding tissue. Yes, any activity that contracts the pectoralis muscle on top of the implant over time could cause the implant to displace towards the lateral chest or armpit area. Revision or reshaping the pocket is not urgent and can be done electively. Your best option is to be examined by your surgeon or a board certified plastic surgeon who can assess your issue and give you options. Good Luck.

John W. Menard, MD · Answer

It would be good advice to limit any very strenuous activities that significantly stimulate the pectoralis muscles until you can asses further the situation. If the process seems to b stable then I would gradually restart the exercises. If the lateral displacement presents a problem for you I would recommend that you see your surgeon to consider a surgical revision.

Stacey Folk, MD · Answer

It sounds as though you made very good decisions with your plastic surgeon when it came to your initial surgery. Textured implants have less risk of lateral displacement, and the texturing surface of each company has unique characteristics as to whether the scar tissue capsule can attach to the surface like Velcro or  act like grip tape and create  a degree of traction. Because you have very little breast tissue placing the implants under the muscle creates a more natural look and feel as well as lower risk of capsular contracture. If you have a very strong pectoralis major muscle, engaging this with certain exercises can certainly force the implant more laterally.  When you see pictures of female bodybuilders their implants are often above the muscle and I personally don’t recall  ever seeing a photo where I thought, “Boy do those implants look great!”. They typically look extremely artificial, and nothing like a natural breast. I would assume you wear some sort of a sports bra or regular bra when you exercise. Finding one that has supportive cups rather than one that smashes your breast flat can help hold them into position when lying on your back and performing some exercises. I would assume also that you would never consider giving up your healthy lifestyle just so your implants don’t drift a little laterally, similar to what real breast do when people lie down.   There is absolutely no reason why anyone has to have surgery for lateral displacement unless it is painful. Most patients describe it as an annoyance and dislike the cleavage area when laying flat on their back. If you were to redo your surgery the new implants will still be exposed to the same environment that allows them to drift laterally. There can be permanent suturing of that capsule, addition of foreign material, or using a more aggressively textured implants, but you still may experience the same issue over time. There are also certainly risks with doing these  interventions that you would have to consider as well.  The vast majority of my patients exercise, and I would never consider asking them not to. If you are really focusing on bodybuilding, that may put you into a different category.  If you are overall happy with your results I would continue to exercise and search for surgery bras with supportive separate cups that are more generous in size, Perhaps with an underwire that is comfortable, and creates less of a smoosh down to your chest wall. Trying to build or create a very strong pectoralis major muscle is also not necessarily in your best interest when it comes to the look of implants. You could possibly use less weight on those specific exercises. Dead lifting  is not an exercise I would think exacerbates the lateral displacement. Chest presses seem more like a problem to me, but you could always discuss this with the trainer.

Anthony J. Taglienti, MD · Answer

Thank you for your question. No, revision is not urgent - but if it is something that bothers you, then you may want to consider a revision in the future. Any activity that activates your pectoralis muscle will continue to move your implants lateral - so, you should avoid these activities. A revision may entail simply scoring the pocket, or placing internal sutures and staying a compressive bra for a couple weeks. It's usually a pretty easy recovery. Best of luck!

Deadlifts and lateral displacement? Is revision urgent?

Answers (6)

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