Correction of Breast Implant Animation Deformity by Conversion to Split Muscle Plane
What Are Animation Deformities?
Animation deformities are distortions of the breast with muscle flexion and are common with implants under the muscle using the dual plane technique. This video will show correction of animation deformity in a patient with a previous breast lift and implants by converting to the split muscle plane. This clip shows the distortion when she flexes her pectoral muscles. At rest, the shape is pretty good except for some bottoming out which will also be fixed. The picture with muscle flexion shows the distortion clearly, although it is different on each side. When an illustration of the pectoral muscle is superimposed you can visualize how the part of the muscle that is cut with the dual plane has adhered to the scar capsule around the implant. The pulling up is called window shading. This illustration of the dual plane shows how the pectoral muscle was cut from its attachment to the ribcage in order to create a space for the implant. The muscle does not cover the bottom or side so it is partly under muscle and partly not: two planes.
Why The Split Muscle Technique?
The split muscle technique leaves the upper part of the muscle in front of the implant but leaves the lower portion behind in its normal position. The split is along the direction of the muscle fibers. The split muscle technique allows for muscle coverage of the implant where it’s most needed, which is in the upper pole. Because the attachments are not disrupted, muscle function is maintained and there is minimal animation. In this patient, we converted from the dual plane to the split muscle plane and reattached the lower portion of the muscle where it had been released. We also did a capsulorrhaphy to elevate the lower fold, and this patient also had a reverse tummy tuck for unrelated reasons. Here she is after surgery actively flexing with minimal distortion. The after photo shows better implant position and good contour when relaxed. The after photo with muscle function shows little distortion.
I developed the split muscle technique around 2004 as a variation of the subfascial method. I use it for correction of animation problems as you’ve seen here and in primary augmentation for prevention of animation.