Breast implant displacement refers to shifting or migration of the breast implants after breast augmentation surgery. Displaced implants may shift upward, downward, inward (toward the breastbone) or outward (toward the armpit). Although occassionally unavoidable, meticulous surgical technique can help avoid implant displacement. Dr. Pfeifer creates a very precise pocket for the implant in order to avoid implant displacement. Patients who request overyly large implants are at greater risk of implant displacement. Because of this and other problems causes by overly large implants, Dr. Pfeifer will not use overly large implants in any patient.
Minor implant displacement may not be noticeable or affect the aesthetic outcome of your breast enhancement, however more significant implant displacement may make it necessary to reposition the implants via revision breast surgery.
Some types of implant displacement are:
- Lateral displacement
- Bottoming out
- High riding
Lateral displacement occurs when breast implants shift towards the armpit. Although it is natural for your breasts to naturally drift toward your armpits when you are lying down, implants should not remain in this position when you are seated or standing upright.
Breast implants that have migrated too far downward, causing the nipple to sit too high on the breast mound. Large, heavy implants may end up bottoming out over time, however over-dissection of the breast pocket may cause your implants to bottom out soon after surgery.
It is not uncommon for breast implants, particular those placed under the muscle, to ride higher on the chest in the immediate post-operative period following breast augmentation because the pectoral muscle is tighter than usual. Within a few months, if your breast implants have not dropped or settled and continue to sit high on your chest, it may be due to the inframammary fold, or breast crease, not being released adequately.
Symmastia (also called kissing implants or breadloafing) refers to breast implant displacement that has caused both implants to migrate inward toward the breastbone, resulting in development of a "uniboob."
Symmastia may present at any time after surgery, although it is one of the most uncommon breast augmentation complications. Over-dissection of the breast pocket typically causes symmastia, however women who have a depressed breastbone are generally more likely to experience the condition.
Causes of breast implant displacement
- Implant size - Larger implants (500cc or more) are typically more prone to displace downward or outward
- Implant placement - Implants placed over the muscle (subglandular) are more likely to displace downward
Preventing breast implant displacement
Choosing the proper size implant helps prevent implant displacement.
Correcting breast implant displacement
Effective correction of lateral displacement, bottomed out implants, symmastia or any other breast displacement deformity requires breast augmentation revision performed by a highly experienced plastic surgeon.
The surgical techniques used to correct each type of breast implant displacement will vary, however capsulorrhaphy, or releasing and re-suturing the capsule (scar tissue) to improve the shape of the implant pocket, is sometimes used. In addition, acellular dermal matrix such as Alloderm or Strattice may be used to support the repair. Pocket conversion is very useful as well. For example, moving the implant from the subpectoral position to a new pocket in the subglandular position. Dr. Pfeifer frequently creates a new subpectoral pocket, the "neo-subpectoral" pocket.
Symmastia repair is a bit different from other displacement repair procedures, as muscle and tissue must be reattached to the breastbone, and internal permanent sutures are placed to hold the implants and reconstructed breast pockets in place. Smaller breast implants are also usually placed during symmastia correction. The neo-subpectoral pocket, pocket conversion and the use of accellular dermal matrix are often used to correct symmastia.
Areolar (around the nipple) or inframammary (along the breast fold) incisions are typically used for revision breast surgery to correct implant displacement, and since these are often the incisions used for the initial breast augmentation, scarring can be kept to a minimum.
Depending on how extensive your breast augmentation revision, you may need anywhere from a few days to a few weeks to recovery from revision surgery for implant displacement correction.