Dr. Joel Aronowitz - Common Complication of Breast Implants Placed Under Muscle: Breasts Sag with Age, Implants Do NOT!
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| Dr. Joel Aronowitz |
Dr. Joel Aronowitz: “Okay, so I wanted to show you a common problem as the breast ages when the implant has been placed under the muscle or a retropectoral implant. Thank you for being a good model. So, she had implants many years ago when the breast was up like this, and now the breast has fallen, but the implant hasn't fallen; it remains under the muscle, and here's how we tell the implant's still under the muscle. If you put your hands on your hips and flex the muscle, now we can see the movement or the animation of the implant. Here's where the scar was, and because that scar goes all the way down to the muscle, it pulls up on the skin. Here's where the muscle is going straight across like this. This fold in our arm, this is the pectoralis muscle, and it's coming straight across like that when she flexes; it does that with the implant, and that's why we see that animation. And then on the lateral side here, you can see how this is raised up here; she's too high up here; it doesn't slope down like a ski slope like a natural breast does because there's a big implant right here under her muscle.
The implant hasn't fallen down as her breast has fallen, so we're going to take out the implant, and then we're going to raise up the breast like this, and then either put a new implant in, which in this case we're not going to, or put a little fat from the tummy into the breast, give it a little bit more volume, or just lift the breast and not have any volume adjustment, and the way the lift is done is we're going to mark where the fold is here, right here is where her fold is where my thumb is, and that's where the nipple belongs is roughly at the level of the fold right here, then we'll move the nipple up and remove the excess skin through an incision down here, and that's a breast lift or a mastopexy, and that's how we do a breast lift, and that's this is the problem from an implant that's placed under the muscle, and with age, the implant doesn't descend but the breast does, and the patient often also has symptoms related to pressure on the ribcage from the implant.
You can see this is pushing out, and physics tells us that the same pressure pushing out on her skin from that implant is the same pressure that the implant is exerting on her ribcage, which is not comfortable, can cause a chronic discomfort, can cause problems with physical activity when you're using your arms and use your arms and otherwise. So that's one of the some of the issues associated with implants placed under the muscle. I hope that helps, and thank you for being good models. Perfect.”
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