Why does my left breast implant shift and crinkle when i flex my pectoral muscle? (photo)

Visible wrinkling of implants is not uncommon in the absence of adequate tissue coverage. Your photos suggest that you have very little native breast tissue and no significant fat. When coverage is largely skin as in your case, the wrinkling of implants will often be visible. A diagnosis of ruptures requires radiologic imaging, most commonly by a high-resolution ultrasound. Regarding your other questions and concerns, a physical examination would be required. A consultation with a board-certified plastic surgeon would be appropriate. He or she can arrange for an ultrasound, discuss options to reduce the rippling, and diagnose and treat your other concerns.

Based on the photos provided, you appear to be very thin with every little fat or breast tissue coverage of the breast implants. this increases the likelihood of visible or palpable wrinkling of the implants. Textured implants also have a thicker shell which increases the probability of wrinkling. A submuscular plane of breast augmentation will minimize this type of wrinkling. Generally implants placed above the muscle ie. prepectoral will not animate or wrinkle with muscle contraction. I therefore can’t explain the wrinkling with contraction unless, perhaps, the surgeon placed the implants subfascial?

Textured implants will attach to underlying structures. If the implants were placed in front of the muscle then they are adhering to the underlying muscle. You would benefit from removal of the textured implants and placing smooth implants instead. If you are concerned about possible rupture, which I doubt, then you can get an ultrasound, mammogram or MRI scar to see if the implants have ruptured.

Best Wishes,

Gary Horndeski, M.D.

Dear witchcraft,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hi! It’s possible you are seeing rippling because you are thin. Even though your implants are above the muscle, your scar tissue capsule is attached to the muscle which could explain seeing a difference when your muscle is flexed. It’s also possible your capsule is slightly thicker or tighter on that side (which is called capsular contracture).

The best way to find out if your implant is ruptured is to get an ultrasound. This can be done anywhere mammograms are performed with a prescription from your family doctor or OB/GYN, but many plastic surgeons also have ultrasound in their office and can do a physical exam and a scan at the same time.

Bottom line, if it isn’t ruptured, there is no need to do anything. If the implant is ruptured, I would plan to replace it as soon as your schedule allows.

Your implants are too large for your frame and tissue. You need to go smaller and consider some mesh for better coverage.

Dear Witchcraft
without knowing what type of implant you have I would be concerned having textured implants at this point in time. Textured implants have the highest incidence of a disease known as ALCL, a rare type of lymphoma. As far as the appearance goes I think your implants are placed in a small pocket and you have a bilateral capsular contracture which is wheezing down on the implants. This is what is giving it that extremely tight look and also makes the nipples appear as if they are facing outwards. Of course these were recommendations are by no means and 4 a consultation in person however I do think switching to smooth round implants placed under the muscle would be a much better option for you especially with the amount of fat you appear to have and breast tissue prior to having ear augmentation. I would suggest seeing a plastic surgeon in your area or anyone you may choose and get a 2nd opinion from him or her.
I wish you good luck with your decision and hopefully you will find a good plastic surgeon near you so you do not have to go to Columbia to have your revision area surgery.
Steven Schuster MD FACS
Boca Raton Florida