High Transverse Capsuloplasty for the Correction of Malpositioned Implants Following Augmentation Mammoplasty in Partial Submuscular Plane

Breast augmentation is one of the most commonly performed procedures today. The complications are few and can be divided into early or late. Early complications include infection and haematoma often requiring emergency interventions. Capsular contracture and implant malplacement are the most common late complications and both can be treated with an elective procedure. Capsular contracture is easily recognised due to change in the breast’s physical characteristics, shape, and accompanying tenderness. On the other hand, implant malplacement, though more common than capsular contracture, is often undertreated. The aim of this study was how to recognise and treat malpositioned implants in a partial submuscular pocket with or without animation or dynamic deformity.

Retrospective data were collected from the pool of revision breast surgeries, and patients with double-bubble deformities and malpositioned implants in the partial submuscular pocket accompanied with varying degrees of dynamic deformity were identified.

Ten patients with malpositioned implants with varying degrees of animation deformity underwent high transverse capsuloplasty for a new pocket creation. The size of the new implants ranged from 350 to 595 cc. All were treated as day cases. With a follow-up period ranging from 1 to 6 years, all patients had good results and a stable new pocket. No revision was required in any of the procedures performed within a follow-up period of at least 1 year.

The high transverse capsuloplasty is an extension of an already described technique and can be used in selected patients with malpositioned implants with or without animation deformity following partial submuscular breast augmentation. Large-volume implants should be used with caution in these patients.