Implant Malposition

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Did your initial breast augmentation lower your infra-mammary fold (IMF) too much or does your breast implant migrate away from the center of your breast, especially when lying down?

Inferior implant malposition occurs when the infra-mammary fold (IMF) stretches out and lateral malposition occurs when the side tissue of the breast stretches. The shape and defining borders of the breasts are affected by natural folds, which should provide gentle curvatures under and on both sides of the breasts. These folds give the breasts definition and help maintain the shape of the breasts and position of the breast implants.

During initial breast augmentation surgery, a pocket is carefully created under the pectoralis major muscle and breast tissue. The IMF and the lateral folds are important landmarks when creating the pocket, and accurate pocket dissection is critical. Unfortunately over time, especially with saline implants, one or both breast pockets can stretch and increase in size, allowing the implant to migrate down or to the side. This may be due to either the loss of skin elasticity or a breakdown of pocket boundaries, affecting the inframammary fold, lateral fold, or both. Should this occur, the breast implant has too much space within the pocket and can move to the side when laying flat or falling too low when standing.

Surgical Correction using Strattice or Seri

Revisionary breast implant surgery is often recommended to minimize fold malposition and improve the appearance of your breasts. This can be done using several techniques including capsulorrhaphy, where tacking sutures are placed within the breast capsule to reconstruct the breast implant pocket and make it smaller. This can be done for the IMF, the lateral fold, or both. If your tissues are weak, if you have larger implants, or if you are at risk for recurrence, Dr. Gordon or Dr. Reid will recommend the use of Strattice™ Reconstructive Tissue Matrix (TM) or Seri for your revision breast surgery. These tissue matrices add support to the repair, decrease stress on your tissues and minimize the chance of recurrence. After reconstruction of the breast implant pocket and reestablishing the inframammary and lateral folds, strips of Strattice™ TM or Seri can be used to redefine the fold location(s) by supporting the fold repair inferiorly or laterally. This will provide extra support to maintain your breasts implants in the proper location over time.

Superior Malposition

Superior malposition of implants can occur if one or both implants do not fully descend after surgery. Scar tissue can form in the lower aspect of the breast near the fold and prevent the natural settling of the implants. This can make the affected breast(s) appear too full in the upper pole. The treatment for this is straightforward and does not require Strattice or Seri. A capsulotomy is performed where the inferior pocket is released, allowing the implant to settle at the level of the IMF.

FAQ’s on Strattice

Every patient is unique, so revision options vary. Dr. Reid and Gordon are experts in breast implant revision surgery. Call 512.371.8817 today to schedule your consultation to discuss your concerns and various revision options.