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.
