Aesthetic Plastic Surgery

, Volume 34, Issue 1, pp 111–115 | Cite as

Capsular Flaps for the Management of Malpositioned Implants After Augmentation Mammoplasty

Innovative Techniques


Among the reasons for reoperation after augmentation mammaplasty is the malpositioned implant, especially a lowered inframammary fold or symmastia, which is difficult to repair. The peri-implant capsule, a physiologic response to a foreign body, is naturally formed and suitable for use as a flap because of its high vascularity. In addition, it is sufficiently tough for suspension of the implant. The authors introduce the idea that the capsular flap is very useful for the correction of symmastia or a lowered inframammary fold. In such situations, the capsular flaps are used to prevent migration of the implant after raising of the inframammary fold or defining of the midline with capsulorrhaphy. This technique successfully corrected the malpositioned implants in this study, and all the patients were satisfied. There was no recurrence of a lowered inframammary fold or symmastia. These findings suggest that the capsular flap should be considered a safe and effective option for the management of malpositioned implants.


Breast augmentation Capsular flap Implant malposition 


  1. 1.
    Bengtson BP, Van Natta BW, Murphy DK, Slicton A, Maxwell GP (2007) Style 410 highly cohesive silicone breast implant core study results at 3 years. Plast Reconstr Surg 120:40S–48SCrossRefPubMedGoogle Scholar
  2. 2.
    Araco A, Gravante G, Araco F, Delogu D, Cervelli V, Walgenbach K (2007) A retrospective analysis of 3,000 primary aesthetic breast augmentations: postoperative complications and associated factors. Aesth Plast Surg 31:532–539CrossRefGoogle Scholar
  3. 3.
    Cunningham B (2007) The mentor core study on silicone MemoryGel breast implants. Plast Reconstr Surg 120:19S–29SCrossRefPubMedGoogle Scholar
  4. 4.
    Spear SL, Little JW (1988) Breast capsulorrhaphy. Plast Reconstr Surg 81:274–279CrossRefPubMedGoogle Scholar
  5. 5.
    Parsa FD (1990) Breast capsulopexy for capsular ptosis after augmentation mammaplasty. Plast Reconstr Surg 85:809–812CrossRefPubMedGoogle Scholar
  6. 6.
    Voice SD, Carlsen LN (2001) Using a capsular flap to correct breast implant malposition. Aesth Surg J 21:441–444CrossRefGoogle Scholar
  7. 7.
    Chasan PE (2005) Breast capsulorrhaphy revisited: a simple technique for complex problems. Plast Reconstr Surg 115:296–301PubMedGoogle Scholar
  8. 8.
    Baxter RA (2003) Intracapsular allogenic dermal grafts for breast implant-related problems. Plast Reconstr Surg 112:1692–1696CrossRefPubMedGoogle Scholar
  9. 9.
    Rubino C, Mazzarello V, Farace F, D’Andrea F, Montella A, Fenu G, Campus GV (2001) Ultrastructural anatomy of contracted capsules around textured implants in augmented breasts. Ann Plast Surg 46:95–102CrossRefPubMedGoogle Scholar
  10. 10.
    Rockwell WB, Casey HD, Cheng CA (1998) Breast capsule persistence after breast implant removal. Plast Reconstr Surg 101:1085–1088CrossRefPubMedGoogle Scholar
  11. 11.
    Imran D, Javaid M, Lewis D, Attar KH (2005) Capsular flap for correction of contour deformities of the breast. Ann Plast Surg 54:662–663CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2009

Authors and Affiliations

  1. 1.Department of Plastic Surgery, College of MedicineThe Catholic University of KoreaSeoulKorea
  2. 2.Apgugeong Avenue Plastic Surgery ClinicSeoulKorea

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