Breast Implant Malposition

Breast Implant malposition occurs when the implant is not in the correct location under the breast. The implant may be too high, too low, too close to the middle, or too far out laterally. Implant malposition may be caused by many different factors, and the treatment is based on the location and cause of malposition.

There are many different ways to manage malposition. The traditional method used to manage malposition involves repairing the internal capsule.  The breast capsule is formed when the implant is placed. In some cases the capsule can be sutured closed in the area of malposition. This procedure is called capsulorrhaphy or capsuloplasty.

One other approach is to create a new pocket for the implant. For example, the pocket may be changed from above the muscle to below the muscle. The new pocket may be dissected to the ideal dimensions for the implant correcting the malposition.

If these techniques are not likely to succeed then a surgical scaffold may be used.  Synthetic surgical scaffolds such as SERI, a silk derived biological scaffold, may be used. The scaffold is used to close off the area of malposition and to reinforce that area with a strong material that will support the implant. Alloderm may also be used. Alloderm is an acellular human dermis. An alternative is porcine acelluar dermis. All of these products are used to support the reconstruction of the pocket.

If the cause of implant malposition is capsular contracture then the management will involve removal of the implant along with the contracted capsule. The new implant may be placed in the same position above or below the muscle or may be changed to a new location above or below the muscle.

Finally, if the implant appears to be in the wrong place due to breast ptosis or sagging of the breast then a breast lift may be necessary. In these cases the implant may be in an appropriate position, but the breast tissue has fallen over time. The breast tissue will require lifting to achieve the desired result.

If you have breast implant malposition and are considering surgery, schedule an appointment with a board certified plastic surgeon like Dr. David Bray, Jr. To schedule an appointment call 310 326-9400.