Breast augmentation is a very common procedure in the United States, and there are different anatomical areas where breast implants can be placed. You can place the implant under the muscle or above the muscle. I prefer putting the implant under the muscle because it is the best anatomical place for a foreign body like a silicone breast implant; it provides good coverage and helps prevent aesthetic complications. Nevertheless, complications can occur with breast augmentation surgery, and one of these is animation deformity after the procedure.
When a breast augmentation is performed, the muscle of the chest is detached and an implant is placed under the muscle. The function of the pectoralis muscle is still going to be there, so when you compress your chest, the muscle will squeeze the implant. In some patients, when this happens, the breast gets distorted This complication is pretty rare, but is more common when the implant is placed completely under the muscle. Most implants that are placed under the muscle are actually partially submuscular, meaning that the top of the implant is covered with the muscle while the rest of the implant is in the subcutaneous plane above the muscle. This is actually the best plane to create the best shape and results, but some surgeons who perform breast augmentations through the belly button or through the axilla place the implant completely under the muscle without detaching the insertion of the pectoralis major muscle like I described before.
If you develop an animation deformity, we need to determine if your implant is completely under the muscle. If it is completely under the muscle, one solution is to move the implant above the muscle. If your implant is in a partial submuscular plane and you have a certain amount of animation deformity, it may be a result of inferior attachment of the pectoralis major muscle because a capsule has been formed around the implant; sometimes, you can fix this issue by cutting the scar and releasing the implant from the surrounding scar formation.
There are different grades of animation deformities. For the most part, they do not bother the patients most of the time. The best way to prevent an animation deformity is to place the implant above the muscle. However, in my opinion, the benefits of having the implant under the muscle, including improved upper-pole soft tissue coverage, camouflage in thin patients, less visible rippling, less visibility of the implant, a lower rate of capsular contracture, and improved visibility of the breast parenchyma on mammogram, are worth the risk of animation deformity.
Breast augmentation can do wonders for a patient, but in reality, you also need to accept the risk of rare complications and their consequences. If you develop an animation deformity, you might need a revision surgery if it bothers you. Most of the time, if you are not compressing the pectorals major muscle, the breast will have a normal shape; even if you have this complication, most likely it is not going to bother you and no surgical revision will be necessary.
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