Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty
Background Implant malposition can produce unsatisfactory aesthetic results after breast augmentation. The goal of this article is to identify aspects of the preoperative surgical planning and intraoperative flap fixation that can prevent implant malposition. Methods This study examined...
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2014-07-01
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| Series: | Archives of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2014.41.4.407 |
| _version_ | 1818033307378515968 |
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| author | Yoon Ji Kim Yang Woo Kim Young Woo Cheon |
| author_facet | Yoon Ji Kim Yang Woo Kim Young Woo Cheon |
| author_sort | Yoon Ji Kim |
| collection | DOAJ |
| description | Background Implant malposition can produce unsatisfactory aesthetic results after breast augmentation. The goal of this article is to identify aspects of the preoperative surgical planning and intraoperative flap fixation that can prevent implant malposition.
Methods This study examined 36 patients who underwent primary dual plane breast augmentation through an inframammary incision between September 1, 2012 and January 31, 2013. Before the surgery, preoperative evaluation and design using the Randquist formula were performed. Each patient was evaluated retrospectively for nipple position relative to the breast implant and breast contour, using standardized preoperative and postoperative photographs. The average follow-up period was 10 months.
Results Seven of 72 breasts were identified as having implant malposition. These malpositions were divided into two groups. In relation to the new breast mound, six breasts had an inferiorly positioned and one breast had a superiorly positioned nipple-areolar complex. Two of these seven breasts were accompanied with an unsatisfactory breast contour.
Conclusions We identified two main causes of implant malposition after inframammary augmentation mammaplasty. One cause was an incorrect preoperatively designed nipple to inframammary fold (N-IMF) distance. The breast skin and parenchyma quality, such as an extremely tight envelope, should be considered. If an extremely tight envelope is found, the preoperatively designed new N-IMF distance should be increased. The other main cause of malposition is failure of the fascial suture from Scarpa's fascia to the perichondrium through an inframammary incision. As well, when this fixation is performed, it should be performed directly downward to the perichondrium, rather than slanted in a cranial or caudal direction. |
| first_indexed | 2024-12-10T06:21:11Z |
| format | Article |
| id | doaj.art-a9241ee21921447da138f9b420476a97 |
| institution | Directory Open Access Journal |
| issn | 2234-6163 2234-6171 |
| language | English |
| last_indexed | 2024-12-10T06:21:11Z |
| publishDate | 2014-07-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj.art-a9241ee21921447da138f9b420476a972022-12-22T01:59:20ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-61712014-07-01410440741310.5999/aps.2014.41.4.407371Prevention of Implant Malposition in Inframammary Augmentation MammaplastyYoon Ji Kim0Yang Woo Kim1Young Woo Cheon2Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, KoreaDepartment of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, KoreaDepartment of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, KoreaBackground Implant malposition can produce unsatisfactory aesthetic results after breast augmentation. The goal of this article is to identify aspects of the preoperative surgical planning and intraoperative flap fixation that can prevent implant malposition. Methods This study examined 36 patients who underwent primary dual plane breast augmentation through an inframammary incision between September 1, 2012 and January 31, 2013. Before the surgery, preoperative evaluation and design using the Randquist formula were performed. Each patient was evaluated retrospectively for nipple position relative to the breast implant and breast contour, using standardized preoperative and postoperative photographs. The average follow-up period was 10 months. Results Seven of 72 breasts were identified as having implant malposition. These malpositions were divided into two groups. In relation to the new breast mound, six breasts had an inferiorly positioned and one breast had a superiorly positioned nipple-areolar complex. Two of these seven breasts were accompanied with an unsatisfactory breast contour. Conclusions We identified two main causes of implant malposition after inframammary augmentation mammaplasty. One cause was an incorrect preoperatively designed nipple to inframammary fold (N-IMF) distance. The breast skin and parenchyma quality, such as an extremely tight envelope, should be considered. If an extremely tight envelope is found, the preoperatively designed new N-IMF distance should be increased. The other main cause of malposition is failure of the fascial suture from Scarpa's fascia to the perichondrium through an inframammary incision. As well, when this fixation is performed, it should be performed directly downward to the perichondrium, rather than slanted in a cranial or caudal direction.http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2014.41.4.407mammaplastybreast implantnipples |
| spellingShingle | Yoon Ji Kim Yang Woo Kim Young Woo Cheon Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty Archives of Plastic Surgery mammaplasty breast implant nipples |
| title | Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty |
| title_full | Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty |
| title_fullStr | Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty |
| title_full_unstemmed | Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty |
| title_short | Prevention of Implant Malposition in Inframammary Augmentation Mammaplasty |
| title_sort | prevention of implant malposition in inframammary augmentation mammaplasty |
| topic | mammaplasty breast implant nipples |
| url | http://www.thieme-connect.de/DOI/DOI?10.5999/aps.2014.41.4.407 |
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