Before and after bilateral breast implant revision in a 51-year-old woman. Breast implants that were placed just two years ago were under the muscle, with typical stigmata of this under-the-muscle augmentation – animation deformity and bottoming-out of her left breast implant.
The pectoralis major muscle, the largest and strongest muscle of the chest, often pulls an implant up higher, causing the “Snoopy deformity”, but it can also push the implant down below the natural breast fold, causing a “double bubble”. This is known as “bottoming-out” (of the implant below the inframammary fold).
She was left-handed, and therefore the deformity was worse on that side due to increased muscle activity and strength. Her aesthetic goal for her breasts was to keep an implant but to have a more natural looking result and improved symmetry.
Her prior inframammary fold scars were used to access the implants. The old implants were removed, her pectoralis major muscles were separated from the undersurface of the breast tissue and were replaced to her chest wall, reconstructing her normal muscular anatomy. A new space was made for an implant on top of the muscle, in the subglandular position.
By converting the implant pocket from under the muscle to on top of the muscle, all issues related to the submuscular implant location (animation deformity, double bubble and bottoming out) were corrected. New smooth round silicone gel breast implants were inserted, and additional suturing of the left inframammary fold reinforced its repair.
Follow up photos are shown 7 months after surgery with her muscles flexed and at rest. She is very happy with her decision to have a revision and wishes that she had been given the option to have subglandular breast augmentation from the start!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
