What submuscular incision causes more animation deformity?

Placing the implant behind the muscle will cause animation when the muscle is tensed. The lowest fibers of the muscle that attach to your sternum can be partially cut to help decrease this movement.

Animation deformity is not a function of incision but rather a function of plane of dissection/implant placement.

Animation is a consequence of muscle activity overlying the implant. If the implant is behind the muscle regardless of whether it is split, released, or left intact, there will be some measure of animation. The movement of of the implant is caused by the movement of the overlying muscle.

If animation is a major concern, subglandular augmention may be preferred.

As always, discuss you concerns with a board certified plastic surgeon (ABPS).

Dear LexieCooper,

I tend to prefer the periareolar incision because its the most well hidden. There is a natural border between the areola and the rest of the breast skin the hides the incision extremely well. You have to be completely naked to see it vs other incisions like transaxillary and inframammary are visible in clothing such as sleeveless shirts and bikini tops when extending your arms up. I've also noticed increased rates of bottoming out with inframmary incisions that is not reported. Transaxillary implants are always wide in appearance because the surgeon is not able to dissect medially enough to provide better cleavage. Ultimately, I can perform any of the incisions but I recommend the periareolar. There is no difference in sensation because the nerves that control nipple sensation come in laterally from the back and injury to them occurs when surgeons dissect to far laterally which is why transaxillary incisions have the highest nipple sensation disruption. There is no difference in breast feeding ability. One study did show a slight increase in capsular contracture with use of periareolar but that study was small and did not incorporate modern techniques such as below muscle placement, keller funnel usage and triple antibiotic irrigation.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery