Window Shading

Window shading breast implants is a possible complication from the use of submuscular breast implants. When the chest muscle is flexed, a crease or dimple forms at the lower medial aspect of the breast that can be unsightly.

During most breast augmentations with submuscular implants, the surgeon elevates the muscle at the bottom of the breast to allow the breast implant to fit correctly. What can happen in some patients is that the muscle moves up toward the top of the breast, and a scar can form between the muscle edge and the surrounding tissues. When the muscle moves, it pinches the skin of the breast and forms a crease. It is only visible when the muscle is activated. You can well imagine how embarrassing this can be in certain situations. It is not harmful to you and it is not associated with pain.

How is window shading corrected?

This problem is best addressed by using ADM, Acellular Dermal Matrix. It is secured to the edge of the muscle and then to the bottom of the breast. It secures the muscle so it does not retract when flexed. This is often combined with a pocket adjustment, possibly a change in implants, and even a lift depending on the circumstances. Moving the breast implant above the muscle may help as well.

Does window shading get worse over time? 

Usually no. It becomes a stable condition that you can certainly live with if you choose.

Can window shading be prevented? 

I think those who develop this condition are just the unlucky ones. It could be related to your anatomy and how your surgery is performed, but this isn’t clear to me. Not every patient who has submuscular implants develops windowshading.

Can you get window shading with subglandular implants? 

No. The muscle is not disturbed and can’t form the abnormal crease on muscle flexion. This is not a reason to choose the subglandular implant position, though. The incidence of windowshading is not known for sure, but it is relatively uncommon.

How successful is the treatment of window shading? 

Treatment by a qualified surgeon is generally successful in most cases. Again, I can’t stress enough that it has to be performed by an experienced plastic surgeon.

What are the downsides to window shading treatment? 

As always, it could be made worse than it was. Infection, malposition of the implant relative to the breast, and a host of other complications can arise. In great hands, it is definitely worth fixing, in my experience.

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