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Aesthetic Plastic Surgery

, Volume 36, Issue 3, pp 590–599 | Cite as

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

  • Umar Daraz KhanEmail author
Original Article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Dynamic deformity Bottoming down Double-bubble deformity Muscle-splitting biplane Capsulorrhaphy Capsuloplasty 

Notes

Disclosure

The author has no conflicts of interest and this research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

References

  1. 1.
    Khan UD (2010) Breast augmentation, antibiotic prophylaxis and infection: comparative analysis of 1628 primary augmentation mammoplasties to assess the role and efficacy of length of antibiotic prophylaxis. Aesthetic Plast Surg 34:42–47PubMedCrossRefGoogle Scholar
  2. 2.
    Khan UD (2011) Augmentation mammoplasty in breasts with port-wine stains. Are these patients at increased risk of haematoma? Aesthetic Plast Surg 35:130–131PubMedCrossRefGoogle Scholar
  3. 3.
    Troilius C (1996) Correction of implant ptosis after a transaxillary subpectoral breast augmentation. Plast Reconstr Surg 98:889–895PubMedCrossRefGoogle Scholar
  4. 4.
    Kjoller K, Holmich LR, Jacobsen PH, Friis S, Jon Fryzek, McLaughlin JK, Lipworth L, Henrikson TF, Jorgensen S, Bittmann S, Olsen JH (2002) Epidemiological investigation of local complications after cosmetic breast implant surgery in Denmark. Ann Plast Surg 48:229–237PubMedCrossRefGoogle Scholar
  5. 5.
    Khan UD (2010) Combining muscle splitting biplane with multilayer capsulorrhaphy for the correction of bottoming down following subglandular augmentation. Eur J Plast Surg 33:259–269CrossRefGoogle Scholar
  6. 6.
    Spear SL, Schwartz J, Dayan JH, Clemens MW (2009) Outcome assessment of breast distortion following submuscular breast augmentation. Aesthetic Plast Surg 33:44–48PubMedCrossRefGoogle Scholar
  7. 7.
    Khan UD (2009) Dynamic breasts: a common complication following partial submuscular augmentation and its correction using muscle splitting biplane technique. Aesthetic Plast Surg 33:353–360PubMedCrossRefGoogle Scholar
  8. 8.
    Baxter RA (2011) Update on the split-muscle technique for breast augmentation: prevention and correction of animation distortion and double bubble deformity. Aesthetic Plast Surg 35:426–429PubMedCrossRefGoogle Scholar
  9. 9.
    Khan UD (2007) Muscle splitting biplane breast augmentation. Aesthetic Plast Surg 31:353–358Google Scholar
  10. 10.
    Baxter RA (2005) Subfascial breast augmentation: theme and variation. Aesthetic Surg J 25:447–453CrossRefGoogle Scholar
  11. 11.
    Spears SL, Little JW III (1988) Breast capsulorrhaphy. Plast Reconstr Surg 81:274–279CrossRefGoogle Scholar
  12. 12.
    Biggs TM, Yarish RS (1990) Augmentation mammoplasty: a comparative analysis. Plast Reconstr Surg 85:368PubMedCrossRefGoogle Scholar
  13. 13.
    Millán Mateo J, Vaquero Peréz MM (2001) Innovative new concepts in augmentative breast surgery. Part II: systematic and drawing. Aesthetic Plast Surg 25:436–442PubMedCrossRefGoogle Scholar
  14. 14.
    Muntan CD, Sundine MJ, Rink RD, Acland RD (2000) Inframammary fold: a histologic reappraisal. Plast Reconstr Surg 105:549–556PubMedCrossRefGoogle Scholar
  15. 15.
    Last RJ (1978) Anatomy regional and applied, 6th edn. Edinburgh, Churchill Livingstone, pp 65–66Google Scholar
  16. 16.
    Schusterman MA (2004) Lowering the inframammary fold. Aesthet Surg J 24:482–485PubMedCrossRefGoogle Scholar
  17. 17.
    Barnett A (1990) Transaxillary subpectoral augmentation in the ptotic breast: augmentation by disruption of the extended pectoral fascia and parenchymal sweep. Plast Reconstr Surg 86:76–83PubMedCrossRefGoogle Scholar
  18. 18.
    Mandrekas AD, Zambacos GJ (2010) Aesthetic reconstruction of tuberous breast deformity. Aesthet Surg J 30:680–692PubMedCrossRefGoogle Scholar
  19. 19.
    Khan UD (2011) Breast and chest asymmetries: classification and relative distribution of common asymmetries in patients requesting augmentation mammoplasty. Eur J Plast Surg 34(5):375–385Google Scholar
  20. 20.
    Pacik PT (2005) Augmentation mammoplasty: enhancing inferomedial cleavage. Aesthet Surg J 25:359–364PubMedCrossRefGoogle Scholar
  21. 21.
    Parsa FD (1990) Breast capsulopexy for capsular ptosis after augmentation mammoplasty. Plast Reconstr Surg 85:809–812PubMedCrossRefGoogle Scholar
  22. 22.
    Rowe NM, Freund R (2005) The autologous internal breast splint: a novel technique for the treatment of post augmentation ptosis. Aesthet Surg J 25:545–664CrossRefGoogle Scholar
  23. 23.
    Chasen PE, Francis CS (2008) Capsulorrhaphy for revisionary breast surgery. Aesthet Surg J 28:63–69CrossRefGoogle Scholar
  24. 24.
    Baxter RA (2003) Intracapsular allogenic dermal grafts for breast implant-related problems. Plast Reconstr Surg 112:1692–1696PubMedCrossRefGoogle Scholar
  25. 25.
    Maxwell PG, Gabriel A (2008) The neopectoral pocket in revisionary breast surgery. Aesthet Surg J 28:463–467PubMedCrossRefGoogle Scholar
  26. 26.
    Spear SL, Carter ME, Ganz JC (2003) The correction of capsular contracture by conversion to “dual-plane” positioning: technique and outcomes. Plast Reconstr Surg 112:456–466PubMedCrossRefGoogle Scholar
  27. 27.
    Khan UD (2009) Correction of acquired symmastia with muscle-splitting biplane implant replacement. Aesthetic Plast Surg 33:605–610PubMedCrossRefGoogle Scholar
  28. 28.
    Khan UD (2009) Breast autoinflation with sterile pus as a marker of implant rupture: single-stage treatment and outcome for five consecutive cases. Aesthetic Plast Surg 33:58–65PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2011

Authors and Affiliations

  1. 1.Re-shape HouseWest Malling, KentUK

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