Dynamic breast deformity in a male

Abstract is not required for Clinical Imagesis not required for Clinical Images (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 7 No. 6, June 2016. ISSN – [0976-3198] Int J Case Rep Images 2016;7(6):416–418. www.ijcasereportsandimages.com Dorp et al. 416 CASE REPORT OPEN ACCESS Dynamic breast deformity in a male Martijn van Dorp, Johan Somville


DISCUSSION
To date, the available research regarding the dynamic breast deformity is based on subpectoral augmentation mammoplasty or implant-based breast reconstruction and no reports have come out regarding the presence of the dynamic breast deformity due to a neoplasm. Dynamic breast deformity, or animation deformity, is a common term in the field of aesthetic breast surgery and may be a result of subpectoral breast augmentation. When creating a subpectoral pocket plane, during augmentation mammoplasty, the overlying musculature retains its contractile ability. As a result the implant will be compressed when the muscle contracts. Typically this movement tends to draw the implant in an upward and outward directions and this directed compression creates a contour deformity in the breast. The deformity can easily be seen when the patient places her hands on the hips and pushes inwards [1].
Especially in the thin patient, the subpectoral plane has the benefit of having enhanced soft-tissue coverage of the prosthetic device. Whereby the potential for visible implant contours is minimalized and the incidence of capsular contraction is reduced. Alternatively, the subglandular plane is provided with the advantage of having more upper pole fullness and no animation deformity [2].
The magnitude of the deformity caused by the animation is highly variable and is usually only minimal to moderate in severity. At times, the degree of distortion of the implant can be dramatic and lead to patient dissatisfaction [3]. In transgender woman, subpectoral implantation carries increased risk of animation deformity due to the masculine pectoralis muscle [4]. Contraction-induced deformities are directly related to muscle strength and inversely related to the amount of breast tissue present [5].
Resolution of the animation deformity in augmentation mammoplasty may be achieved with a pocket change to the subglandular position and suturing the pectoralis major muscle down to the chest wall [1,6]. Also, a biplane pectoralis muscle splitting technique has been described [7]. Alternatively, selective neurectomy of the medial pectoral nerve or botulinum toxin type A has been proposed to prevent the contraction of the pectoralis and may provide relief of muscular distortion [8].

CONCLUSION
Dynamic breast deformity is a common term in the field of aesthetic breast surgery in woman. However, as described in this extraordinary case, the dynamic breast deformity can be observed due to the presence of a subpectoral liposarcoma in a male patient. Khan UD. Dynamic breasts: a common complication following partial submuscular augmentation and its correction using the muscle-splitting biplane

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