No, exercises won’t fix lateral implant displacement.
Lateral displacement is the unpleasant situation where the breast implants creep very far towards the armpit area when the person is lying flat on their back after breast augmentation. It’s like the breasts are sliding off the chest wall. Lateral displacement leads visually to a loss of cleavage, and often the torso looks broad and heavy.
Non-surgical options are usually the first things that women think of in case of any complication, not only lateral displacement. The most straightforward idea is to go and hit the gym. It sounds logical, doesn’t it? If I do chest flyes and presses for my inner chest, it will be stronger and then, later on, the implants should be held closer to the center. Unfortunately, this is one of the most persistent myths in plastic surgery recovery. In reality, chest muscles strengthening can hardly solve lateral displacement issue. Moreover, if your implants are placed underneath the muscles, intensive training of your chest might even make the problem become more noticeable visually. At Lin Europe Clinic, we want to prevent you from experiencing unnecessary frustration and wasting your time at the gym by giving you an explanation of the biomechanics involved.
Muscle or Pocket?
To figure out why exercise is useless as a treatment for lateral displacement, you need to find out what is actually broken. Since the muscle remains intact, the problem is with the pocket where the implant is placed (more precisely, the pocket capsule is compromised).
In a breast augmentation, the surgeon makes a pocket (a space) inside the tissues to house the implant. The edges of this pocket are first your tissues, and later, a layer of scar tissue, the capsule, is formed. The capsule is the tissue surrounding the implant. In the case of lateral displacement, this pocket capsule’s lateral border (the outside wall) has been either overstretched or ruptured.
- One of the major gaps in the patients’ understanding: Chest workouts develop the pectoralis muscle that lies over the entire chest. Implant amount, location and different breast tissue exist on that side of the respective muscle.
- It is quite the opposite: You’ve beefed up the pectoral muscle to the nth degree, but if the breast pocket below that is significantly dilated, the breast implant will simply settle into that newly available space and be further aided by the force of gravity.
“Inner Chest” Exercises Won’t Help
Patients, especially those who do a lot of “inner chest” moves, like cable flyes, dumbbell pullovers, or close-grip presses, are convinced that they can build muscle in the cleavage area and thus push the implants back together.
Actually, there are two main reasons why this can’t happen:
- The chest area where your breasts meet is actually the sternum bone. There are muscles that attach to the side of the sternum while the center of the sternum remains uncovered. Therefore, there is no way that you could develop muscle tissue in the center of the sternum to cover the gap between the breasts.
- In the case of sub-muscular implants, contracting the pectoral muscles indeed results in compressing the implant. Besides that, due to the lateral pocket’s looseness, the implant, which is the path of least resistance, will pop out toward the armpit. Besides contracting the muscle, the implant is “pushed” by the muscle into the loose pocket wall (the muscle is actually helping the displacement problem here and not holding the implant).
Genetics vs. Surgery
On the other hand, the distinction between the two issues has even more importance.
- Wideness of Natural Anatomy: Wide sternum is a feature that certain women have. Among others, the skeletal structure follows the same pattern in these cases as the soft tissues. In these cases, if you lay down and see your implants remain in place, but the gap is wide, you are just seeing normal anatomy.
- The Action of Displacement: If your implants seem well aligned when standing, but are sliding just the right amount to the armpit when you lie down, then you are showing displacement. In other words, the pocket is so big and therefore the implant has so much freedom of movement that it can slide sideways into the armpit. The breakdown of the pocket constrains structure is thus the cause of this problem and it can be due to sleeping on your side too soon after the surgery, implant size, and weak connective tissue among other things.
Capsulorrhaphy – Surgical Revision
In contrast to the overlapping muscle, the torn pocket cannot be closed by the gym and therefore surgical revision is the only treatment option for lateral displacement. In the surgical world, closing the pocket is called capsulorrhaphy.
Think about a dress that is too big. When a dress is too large and does not fit well, a tailor has to sew the seams tighter in order to make it smaller.
- Capsulorrhaphy is the tightening of the capsule. The implant pocket is opened and the loosened lateral wall is identified. Using heavy-duty, permanent sutures, the surgeon then literally sews the lateral border of the pocket to the ribs, thereby ‘taking in the stretch’. What a simple and quick way to solve the problem!
- When the patient’s tissue is too weak, especially post-multiple pregnancies or weight loss, a suture hold might not be enough. Tissue tearing or ‘rip again like wet paper’ is the kind of thing to be expected. Therefore, we utilize a scaffold material like surgical mesh (e.g., Galaflex or Strattice) that serves as an “internal bra,” fortifying the side wall with a material that is stronger than your own skin ensuring the repair will be indefinitely.
Is Fat Grafting An Alternative?
In case your lateral displacement isn’t too severe and you can’t face full surgical revision at the moment, you have the option of Fat Grafting (Lipofilling). Despite the fact that fat grafting will not stop the implant from slipping, it is able to hide the visual defect quite effectively. We take fat from your belly or upper legs and place it where the cleavage would be inside the breasts (medial breast). As you may know from looking at your own shoes, when you put a softer material next to a harder one, the line of separation between the two becomes less obvious. It is the same effect that the bony gap between implants is ‘softened’ by fat grafting. This is merely a cosmetic cover-up and doesn’t get rid of the feeling of sliding that you have. If you have a heavy implant that you can feel physically falling at the side during the night, the only thing that will help you is to tighten the pocket.
Prevention Is Much More Efficient Than Treatment
This is the reason why postoperative protocols are made so strict. Lateral displacement is a challenging issue that needs revision surgery, which means that the patient has to restart the recovery clock and the surgery is complex from a technical point of view.
This is why wearing your surgical bra (which has side panels to prevent sliding) and sleeping on your back for the first 6 weeks is non-negotiable. During those first weeks, the capsule is forming. If you allow the implants to slide laterally while the capsule is soft, the capsule forms in that wide position, and you are left with a permanent sliding path that no amount of push-ups can close.
Frequently Asked Questions About Lateral Displacement
Unfortunately, no. There is no natural mechanism for scar tissue to ‘contract’ once a pocket defect has been enlarged and scar-tissue matured in the stretched state. In fact, the situation usually remains unchanged or deteriorates with the progression of age and the effects of gravity.
Not at all, it is simply an undesirable mark both visually & functionally; it doesn’t imply the implant is broken or hazardous, however, it may cause some discomfort while sleeping.
While wearing a good supportive bra, the implants are kept at the proper central point only during your time wearing it but the moment you remove the bra, implants will slide back to the side because the pocket is still stretched internally.
The recuperation is generally faster than that of the initial breast augmentation, thus you probably would need 1 week leave from work, however, to ensure proper healing of the new sutures you must totally refrain from upper trunk workouts for 6 weeks.
Indeed, normally synthetic meshes or biological matrices which become a part of your tissue and thus provide a permanent structural reinforcement to prevent the pocket from stretching out again are used.
Maxwell, G. P., & Gabriel, A. (2016). Targeted localized capsulorrhaphy for the correction of breast implant malposition. Aesthetic Surgery Journal.
Spear, S. L., et al. (2003). Revision breast augmentation. Plastic and Reconstructive Surgery.
Wan, D., & Rohrich, R. J. (2016). Revisiting the management of capsular contracture in breast augmentation. Plastic and Reconstructive Surgery.
