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Before and after bilateral breast implant revision in a 35-year-old woman with submuscular implants. She had a significant animation deformity when she flexed her pectoralis major muscles, causing one implant to be displaced upward and the other downward.

Her left pec muscle was so tight, it pulled her left shoulder forward and limited her range of motion, visible in the preoperative image with her arms overhead. She also had a “Snoopy deformity,” also called a “waterfall deformity,” where the submuscular implant moves upward with time due to up-and-out muscle pull, resulting in breast tissue falling downward off the implant, causing the appearance of droop.

Her breast revision involved reopening the incisions under her breast, removal of the previously placed implants, returning her pectoralis muscles to the chest wall, and reattaching them back to her ribs and sternum. She liked her current implant size, so similar new smooth round silicone gel breast implants were placed on top of the muscle, in the subglandular position. Simply converting this patient’s implants from submuscular to subglandular solved all her issues.

Early follow up photos are shown 1 week after surgery. She had begun implant massage and is very grateful to know that (1) her implants are covered under warranty for 20 years, (2) she does not need any additional surgery in the future unless she has a problem or wants a change and (3) we will follow her forward in time for as long as she has her breast implants.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton