Submuscular breast implants are an augmentation procedure with many benefits. But it also has risks, such as delayed healing, displacement or reshaping of the implant, and distortion of the cataract.
Ahead, plastic surgeons explain the potential downsides of submuscular breast implants.
Although you may start to feel healed 2 to 4 weeks after surgery, healing takes an average of 6 to 8 weeks, she says Constance M. Chen, MDboard certified plastic surgeon and breast reconstruction specialist based in New York.
For reference, recovery after a fat transfer breast augmentation procedure generally takes 1 to 2 weeks.
First, scar tissue must form around the capsule. “Then any tissues that touch each other are merged,” he says.
Exercising or attempting other vigorous movements too soon after surgery can disrupt this process.
“If a person with breast implants under the muscle, for example, starts exercising the upper body before the tissues have fully healed, they can push the breast implants into the armpits or in weird places because the tissues have not yet fused.” , he explains. Chen.
“You can also slow down the healing process if you’re not getting enough nutrients, smoking, taking steroids, or not prioritizing your health and wellness,” she says.
Dynamic deformation – also known as motion deformation – involves movements in the implant.
The distortion happens specifically when the chest muscles are activated and engaged, he says Alexander Zuriarrain, MDquadruple board certified plastic surgeon with Zuri Plastic Surgery in Miami, Florida.
Often, people with dynamic deformity say that the implant looks:
- as if protruding
- squeezed
- wizened
- wavy
- bulbous
Some people may also feel pain with visible deformity.
“While the contraction of the breast muscle can compress the breast implant and cause a temporary slight change in shape, this subsides quickly after the muscle relaxes,” he says. Glenn Vallecillos, MDboard certified Plastic Surgeons based in Beverly Hills, California.
“The issue is never permanent,” he says. That said, the only way to prevent it from happening even temporarily is to undergo surgery, usually one of the two procedures described below.
Prophylactic revision involves removing the implant below the muscle and placing a new implant on top of the muscle.
Grafting and autologous reconstruction also involve removal of the implant. But here, the doctor replaces the implant with a graft of your own tissue.
Modern breast implants are usually made of a cohesive silicone gel andthey maintain their shape over time, Vallecillos says.
However, the implant may temporarily flatten when your chest muscle contracts.
When your chest muscles contract, they push against anything underneath the muscles. This can change the shape and appearance of your breast while your muscles are contracting.
Although there are no health risks associated with flattening, it is a concern that athletes and bodybuilders, in particular, may take steps to treat.
For example, wearing a padded sports bra or a looser workout shirt can help hide the temporary flattening.
Prophylactic revision and graft and autologous reconstruction are the two main surgical corrections.
Submuscular breast implants usually don’t open, Zuriarrain says.
But when people flex their chest muscles, some people report an indentation where the muscle ends.
This is usually only apparent when they flex their chest muscles. People bothered by this may choose to correct it with preventive revision or grafts and autologous reconstruction.
This happens when the breast implant “freezes” while the rest of the breast tissue continues to grow, change shape, or fall due to gravity.
If the pre-existing breast tissue begins to “fall out,” the implant may look like a hard, bulbous lump with the remaining tissue hanging or shedding.
It usually happens years and years after the initial breast augmentation, Chen says.
Cataract breast deformity is more common in people who had a breast lift and breast augmentation at the same time, according to Zuriarrain.
“When you have an augmentation breast lift, you are adding weight to the breast at the most critical time of the breast lift incisions healing,” she explains. This increases the risk that the incisions will stretch, creating thicker scars and leading to faster stretching of the breast skin.
Ideally, you will have a breast lift first. Then, after at least 6 months of healing, have the implants placed, he says. “This gives you the best chance of avoiding breast sagging,” adds Zuriarrain.
Cataract distortion can also occur if your surgeon places the implant too high. Although, even then, it’s much more common in people who already have a decent amount of breast tissue over the implant.
To correct this, you can replace and reposition the implant, remove the implant and place a fat transfer, or undergo a breast lift.
How long do breast implants under the muscle last?
The implants last for about 10 years, regardless of whether doctors place them above or below the muscles, Zuriarrain says.
Can breast implants fall out under the muscle?
It’s unlikely that the implant itself will fail, Vallecillos says.
“But over time, breast tissue can hang over the breast implant and surrounding capsule and create the cataract deformity,” she says.
Doctors can correct it surgically.
How common is capsular contracture under the muscle?
“Capsular contracture is by far the most common problem with submuscular breast implants,” says Vallecillos.
“Capsular contracture is usually characterized by breast induration, a painful or tight feeling in the breast, a new tingling sensation in the breast, or a misshapen breast shape.”
An earlier study suggested up to 30% of people with implants develop capsular contracture — but it may be even more common, he says. “The problem is that cases of capsular contracture are underreported.”
How do you know if your breast implants are causing complications?
If your implants are under your pectoral muscle and seem to be moving into your armpit, then you should talk to a professional, says Chen.
“If you have an infected breast implant, you’ll have a high fever and chills, and your breast may be warm, red, and tender,” says Chen.
“Leaking saline implants can be easily recognized by the patient because the breast shrinks,” he says. “Silicone implant rupture is usually silent.”
In some cases, the breast itself can grow unexpectedly due to inflammation caused by leaking silicone, she says.
If you’re trying to figure out which type of breast augmentation procedure is best, it’s a good idea to learn more about the potential risks.
However, the likelihood of each potential risk varies, depending on breast size, implant size, age, overall health, and more.
Always consult a healthcare professional before ruling out or opting for any procedure.
If you have implants and notice a change in the shape, texture, size or temperature of your breast, contact your surgeon or other healthcare professional as soon as possible.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist committed to helping people feel their best in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing recreational products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad in bed. Follow her on Instagram @Gabriellekassel.
