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Breast implant malposition: risk factors, classification, prevention, and surgical treatment

Breast implant malposition: risk factors, classification, prevention, and surgical treatment

Authors:
Анатолий Михайлович Грицюк,
Ирина Геннадьевна Мариничева,
Наталья Евгеньевна Мантурова,
Элеонора Анатольевна Магритт,
Наталья Станиславовна Татаурщикова

Журнал: Пластическая хирургия и эстетическая медицина. 2026;(2-2):94-102.

DOI: 10.17116/plast.hirurgia202602294

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Abstract

OBJECTIVE

To summarize current data on causes, risk factors, classification, prevention, and surgical treatment of breast implant malposition; to identify limitations of modern evidence base.

MATERIAL AND METHODS

A narrative literature review was devoted to breast implant malposition after aesthetic augmentation, revision procedures, and implant-based breast reconstruction. We reviewed the PubMed, Scopus, Web of Science, Google Scholar, and eLibrary.ru databases. The review included studies containing eligible data on etiology, risk factors, classification, corrective methods, complications, recurrences, and long-term outcomes. Qualitative analysis was performed without quantitative synthesis due to heterogeneity of available data.

RESULTS

Breast implant malposition should be regarded not as a single complication but as a group of deformities associated with failure of specific implant pocket boundaries, soft-tissue characteristics, implant plane selection, and implant properties. In primary aesthetic augmentation, the incidence of clinically significant malposition is approximately 1.5—8%. In reconstructive practice, the rate of lateral and inferior malposition reaches 9.8%. The most consistent data concern prevention, including precise pocket creation, preservation or reconstruction of inframammary fold, matching implant dimensions to tissue capacity, and consideration of muscular component in subpectoral placement. Data on surgical treatment remains predominantly retrospective and heterogeneous. The most common techniques include capsulorrhaphy, capsular flaps, implant plane change, inframammary fold reconstruction, and internal pocket reinforcement.

CONCLUSION

Durable results after surgical treatment of breast implant malposition are determined by precise identification of deformity mechanism and complete restoration of implant bed support. The most significant data concern prevention, while results of surgical correction indicate the need for further standardization and accumulation of comparable data on complications and recurrences.

Keywords

  • implant malposition
  • augmentation mammoplasty
  • breast augmentation

Дата поступления: 23.03.2026

Дата принятия в печать: 14.04.2026

Дата публикации: 21.05.2026

References
  1. International Society of Aesthetic Plastic Surgery. ISAPS International Survey on Aesthetic/Cosmetic Procedures Performed in 2024. Accessed March 25, 2026. https://www.isaps.org/media/razfvmsk/isaps-global-survey-2024.pdf
  2. Khanna J, Incze T. Breast implant malposition: prevention, assessment, and treatment. Clinics in Plastic Surgery. 2026;53(2):307-319. https://doi.org/10.1016/j.cps.2025.11.012
  3. Denney BD, Cohn AB, Bosworth JW, Kumbla PA. Revision Breast Augmentation. Seminars in Plastic Surgery. 2021;35(2):98-109. https://doi.org/10.1055/s-0041-1727272
  4. Pacifico MD, Goddard NV, Harris PA. Classification of breast implant malposition. Aesthetic Surgery Journal. 2024;44(10):1032-1042. https://doi.org/10.1093/asj/sjae084
  5. Guarín DE, Victoria FE, Arias JR, Fernández López DF. Breast implants displacement, a review of literature and classification proposal. Cirugia Plástica Ibero-Latinoamtricana. 2021;47(3):239-248. https://doi.org/10.4321/s0376-78922021000300003
  6. Fracol ME, Qiu CS, Chiu WK, Feld LN, Shah N, Kim JYS. Lateral and inferior implant malposition in prosthetic breast reconstruction: incidence and risk factors. Plastic and Reconstructive Surgery — Global Open. 2020;8(5): e2752. https://doi.org/10.1097/GOX.0000000000002752
  7. McGuire P, Reisman NR, Murphy DK. Risk factor analysis for capsular contracture, malposition, and late seroma in subjects receiving Natrelle 410 form-stable silicone breast implants. Plastic and Reconstructive Surgery. 2017;139(1):1-9. https://doi.org/10.1097/PRS.0000000000002837
  8. Weltz TK, Larsen A, Hemmingsen MN, Ørholt M, Rasmussen LE, Andersen PS, Sarmady F, Elberg JJ, Vester-Glowinski PV, Herly M. Breast augmentation with microtextured anatomical implants in 653 women: indications and risk of rotation. Plastic and Reconstructive Surgery. 2021;147(6): 940e-947e. https://doi.org/10.1097/PRS.0000000000007991
  9. Strasser EJ. Results of subglandular versus subpectoral augmentation over time: one surgeon’s observations. Aesthetic Surgery Journal. 2006;26(1):45-50. https://doi.org/10.1016/j.asj.2005.11.007
  10. Mishin A, Kartasheva A, Okhotin V, Ganshin I. Techniques for Retaining the Inframammary Fold in Implant-Based Reconstructive Breast Surgery. European Journal of Breast Health. 2025;21(3):190-199. https://doi.org/10.4274/ejbh.galenos.2025.2025-2-1
  11. Di Edwardo CA, Sati SA. Breast implant malposition: prevention and correction. In: Shiffman MA, ed. Breast Augmentation: Principles and Practice. Berlin: Springer; 2009;573-582. https://doi.org/10.1007/978-3-540-78948-2_65
  12. Namnoum JD, Largent J, Kaplan HM, Oefelein MG, Brown MH. Primary breast augmentation clinical trial outcomes stratified by surgical incision, anatomical placement and implant device type. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2013;66:1165-1172. https://doi.org/10.1016/j.bjps.2013.04.046
  13. Moliver CL, Sanchez ER, Kaltwasser K, Sanchez RJ. A muscular etiology for medial implant malposition following subpectoral augmentation. Aesthetic Surgery Journal. 2015;35(7):NP203-NP210. https://doi.org/10.1093/asj/sjv072
  14. Guillier D, Sapino G, Watfa W, Raffoul W, di Summa PG. Surgical treatment of symmastia: A systematic review of techniques, outcomes and complications. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2021;74(3): 449-462. https://doi.org/10.1016/j.bjps.2020.08.138
  15. Handel N. The double-bubble deformity: cause, prevention, and treatment. Plastic and Reconstructive Surgery. 2013;132(6):1434-1443. https://doi.org/10.1097/01.prs.0000434405.91316.9
  16. Juan AN, Li YU. Advancement of complications related to augmentation mammoplasty using silicone gel prosthesis. Chinese Journal of Plastic and Reconstructive Surgery. 2020;2(1):51-58. https://doi.org/10.1016/S2096-6911(21)00009-1
  17. Salgarello M, Visconti G. Staying out of double-bubble and bottoming-out deformities in dual-plane breast augmentation: anatomical and clinical study. Aesthetic Plastic Surgery. 2017;41(5):999-1006. https://doi.org/10.1007/s00266-017-0918-8
  18. Muntan CD, Sundine MJ, Rink RD, Acland RD. Inframammary fold: a histologic reappraisal. Plastic and Reconstructive Surgery. 2000;105(2): 549-556. https://doi.org/10.1097/00006534-200002000-00011
  19. Kalaria SS, Henderson J, Moliver CL. Iatrogenic symmastia: causes and suggested repair technique. Aesthetic Surgery Journal. 2019;39(8):863-872. https://doi.org/10.1093/asj/sjy217
  20. Chopra K, Gowda M, Kim JYS. Techniques to repair implant malposition after breast augmentation: a review. Aesthetic Surgery Journal. 2016;36(5): 578-586. https://doi.org/10.1093/asj/sjv261
  21. Sanchez ER, Howland N, Kaltwasser K, Moliver CL. Anatomy of the sternal origin of the pectoralis major: implications for subpectoral augmentation. Aesthetic Surgery Journal. 2014;34(8):1179-1184. https://doi.org/10.1177/1090820X14546370
  22. Arquero PS, Zanata FC, Ferreira LM, Nahas FX. Capsular Weakness around Breast Implant: A Non-Recognized Complication. World Journal of Plastic Surgery. 2015;4(2):168-174.
  23. Hartmann R, Weiherer M, Schiltz D, Baringer M, Noisser V, Hösl V, Eigenberger A, Seitz S, Palm C, Prantl L, Brébant V. New aspects in digital breast assessment: further refinement of a method for automated digital anthropometry. Archives of Gynecology and Obstetrics. 2021;303(3):721-728. https://doi.org/10.1007/s00404-020-05862-2
  24. Calobrace MB, Schwartz MR, Zeidler KR, Pittman TA, Cohen R, Stevens WG. Long-term safety of textured and smooth breast implants. Aesthetic Surgery Journal. 2017;38(1):38-48. https://doi.org/10.1093/asj/sjx157
  25. Hallab NJ, Samelko L, Hammond D. Particulate debris released from breast implant surfaces are highly dependent on implant type. Aesthetic Surgery Journal. 2021;41(7):NP782-NP793. https://doi.org/10.1093/asj/sjab051
  26. Munhoz AM. Relevance of breast silicone elastomer surface roughness and area to the inflammatory process and immune system activation: Is it time to reexamine this issue? Aesthetic Surgery Journal. 2021;41(8):NP1129-NP1131. https://doi.org/10.1093/asj/sjab068
  27. Sforza M, Hammond DC, Botti G, Hedén P, Chacón Quirós M, Munhoz AM, Kinney BM, Corduff N. Expert Consensus on the Use of a New Bioengineered, Cell-Friendly, Smooth Surface Breast Implant. Aesthetic Surgery Journal. 2019;39(Suppl_3):S95-S102. https://doi.org/10.1093/asj/sjz054
  28. Montemurro P, Papas A, Hedén P. Is rotation a concern with anatomical breast implants? A statistical analysis of factors predisposing to rotation. Plastic and Reconstructive Surgery. 2017;139(6):1367-1378. https://doi.org/10.1097/PRS.0000000000003387
  29. Ismagilov AKh, Obidennov DS, Obidennov SA, Vanesyan AS. Prevention and treatment of horizontal malposition of implants (telemastia and synmastia) after breast augmentation. Voprosy` rekonstruktivnoj i plasticheskoj xirurgii. 2025;28(2):5-14. (In Russ.). https://doi.org/10.52581/1814-1471/93/01
  30. Stanizzi A, Tartaglione C. Use of acellular dermal matrix for the correction of breast implant malposition. In: Shiffman MA, ed. Breast Reconstruction. Cham: Springer; 2016: 1515-1529. https://doi.org/10.1007/978-3-319-18726-6_150
  31. Chasan PE, Francis CS. Capsulorrhaphy for revisionary breast surgery. Aesthetic Surgery Journal. 2008;28(1):63-69. https://doi.org/10.1016/j.asj.2007.07.007
  32. Haiavy J, Frenzel CA. Correction of implant malposition with capsulorrhaphy: a retrospective review and implementation of patient survey. American Journal of Cosmetic Surgery. 2011;28(2):75-83. https://doi.org/10.1177/074880681102800204
  33. Spear SL, Little JW3rd. Breast capsulorrhaphy. Plastic and Reconstructive Surgery. 1988;81(2):274-279. https://doi.org/10.1097/00006534-198802000-00026
  34. Randquist C, Cohen R. Commentary on: popcorn capsulorrhaphy in revision aesthetic breast surgery. Aesthetic Surgery Journal. 2020;40(1):75-77. https://doi.org/10.1093/asj/sjz062
  35. Harris R, Raphael P, Harris SW. Thermal capsulorrhaphy: a modified technique for breast pocket revision. Aesthetic Surgery Journal. 2014;34(7): 1041-1049. https://doi.org/10.1177/1090820X14542650
  36. Calobrace MB, Mays C, Wilson R, Wermeling R. Popcorn capsulorrhaphy in revision aesthetic breast surgery. Aesthetic Surgery Journal. 2020;40(1):63-74. https://doi.org/10.1093/asj/sjy324
  37. Awaida CJ, Paek L, Danino MA. A new technique for breast pocket adjustment: argon beam thermal capsulorrhaphy. Plastic and Reconstructive Surgery — Global Open. 2022;10(7):e4437. https://doi.org/10.1097/GOX.0000000000004437
  38. Sharobaro VI, Karepetyan GE, Kononets OA, Rozova DK, Burdin SA. Correction of problems associated with breast implants. Plastic Surgery and Aesthetic Medicine. 2025;1:116-123. (In Russ.). https://doi.org/10.17116/plast.hirurgia2025011116
  39. Yoo G, Lee PK. Capsular flaps for the management of malpositioned implants after augmentation mammoplasty. Aesthetic Plastic Surgery. 2010; 34(1):111-115. https://doi.org/10.1007/s00266-009-9456-3
  40. Maxwell GP, Gabriel A. The neopectoral pocket in revisionary breast surgery. Aesthetic Surgery Journal. 2008;28(4):463-467. https://doi.org/10.1016/j.asj.2008.04.005
  41. Kaufman D. Pocket reinforcement using acellular dermal matrices in revisionary breast augmentation. Clinics in Plastic Surgery. 2012;39(2):137-148. https://doi.org/10.1016/j.cps.2012.02.001
  42. Lee HK, Jin US, Lee YH. Subpectoral and precapsular implant repositioning technique: correction of capsular contracture and implant malposition. Aesthetic Plastic Surgery. 2011;35(6):1126-1132. https://doi.org/10.1007/s00266-011-9714-z
  43. Lesavoy MA, Trussler AP, Dickinson BP. Difficulties with subpectoral augmentation mammaplasty and its correction: the role of subglandular site change in revision aesthetic breast surgery. Plastic and Reconstructive Surgery. 2010;125(1):363-371. https://doi.org/10.1097/PRS.0b013e3181c2a4b0
  44. Qiao C, Shi Z, Xu J, Miao J, Yan K, Yan S, Qu Y, Wu G. Precapsular Pocket Repositioning: An Effective Technique for Correcting Implant Malposition in Revision Breast Augmentation. Aesthetic Plastic Surgery. 2025;49(22): 6303-6310. https://doi.org/10.1007/s00266-025-04964-z
  45. Hauch A, Aycock JK, Dowlati S, Hudson M, Vu K, Kenkel JM. Subpectoral implant repositioning with partial capsule preservation: treating the long-term complications of subglandular breast augmentation. Aesthetic Surgery Journal Open Forum. 2021;3(2):ojab009. https://doi.org/10.1093/asjof/ojab009
  46. Escandón JM, Weiss A, Christiano JG, Langstein HN, Escandón L, Prieto PA, Gooch JC, Manrique OJ. Prepectoral versus subpectoral two-stage implant-based breast reconstruction: U.S. medical center experience and narrative review. Annals of Translational Medicine. 2023;11(12):411. https://doi.org/10.21037/atm-23-1094
  47. Elfieshawy H, Smyth G. Autologous lipo-dermal advancement flap for inframammary fold reconstruction: a technical note for prevention and management of caudal breast implant migration. American Journal of Cosmetic Surgery. 2024;41(1):45-50. https://doi.org/10.1177/07488068231186742
  48. Wessels L, Murphy S, Merten S. The capsular hammock flap for correction of breast implant ptosis. Aesthetic Plastic Surgery. 2014;38(2):354-357. https://doi.org/10.1007/s00266-014-0274-x
  49. Fedosov SI, Onnitsev IE, Perekhodov SN, Fedosova KYu. Percutaneous correction of caudal breast implant malposition after augmentation mammoplasty. Plastic Surgery and Aesthetic Medicine. 2025;4:37-40. (In Russ.). https://doi.org/10.17116/plast.hirurgia202504137
  50. Ismagilov AKh, Pushkarev AV, Galeev MG, Vanesyan AS. Acellular dermal matrices in breast reconstruction. Plastic Surgery and Aesthetic Medicine. 2023;3:139-144. (In Russ.). https://doi.org/10.17116/plast.hirurgia2023031139
  51. Movassaghi K, Gilson A, Stewart CN. Prepectoral two-stage implant-based breast reconstruction with poly-4-hydroxybutyrate for pocket control without the use of acellular dermal matrix: a 4-year review. Plastic and Reconstructive Surgery. 2024;154(1):15-24. https://doi.org/10.1097/PRS.0000000000010914
  52. Meshkin DH, Firriolo JM, Karp NS, Salibian AA. Management of complications following implant-based breast reconstruction: a narrative review. Annals of Translational Medicine. 2023;11(12):416. https://doi.org/10.21037/atm-23-1384
  53. King CA, Masanam MK, Tousimis EA, Salzberg CA. Literature review and guide for optimal position in implant-based breast reconstruction. Gland Surgery. 2023;12(8):1082-1093. https://doi.org/10.21037/gs-23-78
  54. Susini P, Marcaccini G, Giardino FR, Pozzi M, Volanti F, Nisi G, Cuomo R, Grimaldi L. Selective Capsulotomies and Partial Capsulectomy in Implant-Based Breast Reconstruction Revision Surgery. Breast Journal. 2024;2024:9097040. https://doi.org/10.1155/2024/9097040
  55. Wong GH, Hamilton S. A systematic review of mesh support of the breast in aesthetic breast surgery. JPRAS Open. 2025;45:185-198. https://doi.org/10.1016/j.jpra.2025.06.001
  56. Fallon S, Odorico SK, Gharavi A, Yang E, Harless C, Vijayasekaran A. Subpectoral to prepectoral pocket change in implant-based breast reconstruction: A retrospective cohort study at a single institution. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2025;110:54-59. https://doi.org/10.1016/j.bjps.2025.09.005
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