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Breast Implant Malposition Correction

Before + After Photo Gallery

Case #1

This 26 year old woman had breast implants inserted several years earlier and over time, noticed that they were progressively “dropping.” This caused her to have a very unusual appearance to her breasts. She underwent corrective surgery which consisted of a capsuloplasty to correct the level of the breast crease and insertion of a new pair of 400 cc Moderate Profile Plus round silicone gel filled breast implants. Her postoperative result is shown six months after the corrective surgery.

Breast Implant Malposition Correction Surgery Beverly Hills

Breast Implant Malposition Correction Surgery Beverly Hills

Case #2

This 29 year old woman had subpectoral saline implants inserted elsewhere. Over time, she noted dropping or descent of the left breast implant. She presented with significant breast asymmetry. The patient underwent corrective surgery consisting of conversion from subpectoral saline implants to subglandular silicone gel filled breast implants. She has 375 cc High Profile round gel implants, and her postoperative result is shown nine months after the corrective surgery.

Case #3

This 31 year old woman complained that her right implant was “too low” and there was too much space between her breasts. She wanted to have better symmetry and improve cleavage. Her surgical correction consisted of removal of her saline implants and insertion of a new pair of 350 cc Moderate Profile Plus round silicone gel filled breast implants in the subglandular position. At the same time, the pocket was modified to improve her cleavage and also to raise the fold on the right side to match the left breast. Her postoperative result is shown one year after corrective surgery.

Breast Implant Malposition Correction Surgery Beverly Hills

Breast Implant Malposition Correction Surgery Beverly Hills

Case #4

This 26 year old woman had breast implant surgery elsewhere and presented with severe “bottoming out” of her implants. Both implants had descended very low on her chest making the nipple appear much too high on the breast mound. The patient underwent corrective surgery consisting of capsulorrhaphy to produce the dimensions of the periprosthetic pocket and insertion of a new pair of 275 cc High Profile round silicone gel filled breast implants. Her postoperative result is shown six months after the corrective surgery.

Case #5

This patient presented with implants that were “too high.” This gave her breasts an abnormal configuration with the nipple appearing to “hang down.” The patient underwent corrective surgery consisting of removal of her implants, conversion from the subpectoral to the subglandular plane and modification of the periprosthetic space with insertion of a new pair of 450 cc Moderate Profile Plus round silicone gel filled breast implants. Her postoperative result is seen eight months after the corrective surgery.

Breast Implant Malposition Correction Surgery Beverly Hills

Breast Implant Malposition Correction Surgery Beverly Hills

Case #6

This woman, who is 37 years old, had a breast augmentation ten years earlier. Over time, she noticed descent and malposition of her right breast implant, giving a very asymmetrical and unusual configuration to her breasts. She underwent corrective surgery which consisted of removal of both of her implants, correction of synmastia, modification of the pocket and insertion of a new pair of 250 Moderate Profile Plus round silicone gel filled breast implants. Her postoperative result is seen nine months after the corrective surgery.

Case #7

This 27 year old woman had breast implants inserted two years previously. Over time, she noted descent of the implants so that the inframammary fold was too low (bottoming out). Also, the scars, which were supposed to be hidden in the crease, were obvious on the anterior surface of her breasts. The corrective surgery consisted of a capsuloplasty to modify the pocket and raise the inframammary crease. A new pair of 275 cc Moderate Profile Plus silicone gel filled breast implants was inserted. The patient’s postoperative result is shown one year after the corrective surgery.

Breast Implant Malposition Correction Surgery Beverly Hills

Breast Implant Malposition Correction Surgery Beverly Hills

Case #8

This patient had upward malposition of her right breast implant causing an unsightly bulge above the right breast. The corrective surgery consisted of enlargement of the pocket on the right side to lower the fold, modification of the pocket on the left side for symmetry and insertion of a new pair of 250 cc Moderate Profile Plus round silicone gel filled breast implants. Her postoperative result is seen four months following the corrective surgery.

Case #9

This patient had breast asymmetry due to upward migration of her left breast implant. This caused an unsightly bulge of the upper half of her left breast. The patient underwent removal of both breast implants, modification of the pockets to create better symmetry and insertion of 350 cc High Profile silicone gel filled breast implants on both sides. The patient’s postoperative result is shown nine months after the corrective surgery.

Breast Implant Malposition Correction Surgery Beverly Hills

Breast Implant Malposition Correction Surgery Beverly Hills

Case #10

This 29 year old woman had a breast augmentation approximately eight years earlier. She developed descent with malposition of the implant on the left side. She presented with asymmetry at the level of the folds (bottoming out on the left side) as well as apparent nipple “malposition.” The corrective surgery consisted of removal of the existing implants, capsuloplasty to raise the fold on the left side, insertion of an ADM graft to support the repair and insertion of a new pair of 350 cc silicone gel filled breast implants. The patient’s postoperative result is shown two years after the corrective surgery.

Santa Barbara Breast Implant Malposition Plastic SurgeryBREAST IMPLANT MALPOSITION

Among the post surgical problems that may be seen in association with breast implants is “implant malposition.”  Implant malposition refers to abnormal positioning of the breast implant.  Sometimes, breast implants can be too high (This is frequently seen in conjunction with capsular contracture), but they can also be too low (a condition sometimes referred to as “bottoming out”), or they can be too far off to the side or even too close to the midline (a condition known as “synmastia”).  Corrective surgery to treat implant malposition is one of Dr. Handel’s areas of special interest.  He has extensive experience in correcting all types of breast implant malposition. When implants are positioned too low (bottoming out or descent of the inframammary fold), surgery typically consists of a procedure designed to reconfigure the periprosthetic pocket and raise the inframammary fold (crease beneath the breast).  Sometimes, this is done in conjunction with insertion of a new breast implant.  Dr. Handel has found that when it is possible to convert implants from the subpectoral or submuscular position to the submammary or subglandular position, this often facilitates the ability to correct downward malposition of the implants and also ensures a longer-lasting result.  Beverly Hill’s Dr. Handel has done extensive research and has written numerous articles and book chapters and frequently gives lectures on the topic of correcting implant malposition.  He is familiar with all current techniques available to achieve the best possible results. When implants are displaced too far to the side (lateral malposition), the treatment is similar to when the implants are displaced in the downward direction.  Again, an operation to modify the periprosthetic pocket is generally performed which is sometimes called a capsuloplasty or capsulorrhaphy.  Also, as with downward implant malposition, it may be advisable to convert the implant from the submuscular to the subglandular or submammary position and sometimes, insert a new breast implant. When implants are displaced too close to the midline, patients lose normal cleavage.  This is a condition referred to by plastic surgeons as synmastia.  While there are a number of techniques available to correct synmastia, Dr. Handel has found that “conversion” of the implant to a “virgin pocket” is often the most effective technique in achieving the desired cosmetic appearance and ensuring long-lasting results.  By converting the implant to a “virgin” pocket (brand new space), it is possible to carefully control the extent of pocket dissection and eliminate abnormal medial malpositioning of the breast implant.  Sometimes, synmastia repair also calls for the placement of new implants. There is a condition known as “double bubble deformity” which is closely related to downward implant malposition.  The double bubble deformity occurs most frequently in patients who have an anatomical predisposition to this deformity.  These are patients who have either a tight lower pole of the breast, a short distance from the nipple to the native inframammary crease, or a so-called “tuberous” or “tubular” breast.  Dr. Handel has extensive experience in treating the double bubble deformity regardless of what caused it. Usually, a double bubble deformity is treated by repairing the periprosthetic capsule (reducing the amount of space as indicated) and/or converting the implant to a new pocket, either to a neosubpectoral pocket or a subglandular pocket.  Oftentimes, a new breast implant is inserted at the same time.  Dr. Handel has considerable experience with correction of double bubble, he has written book chapters and articles about the double bubble deformity and is often invited as a guest speaker at plastic surgery meetings and symposia to educate other plastic surgeons about this anomaly and the best ways to treat it.

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