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Breast Implants - Malposition

Breast implant mal-position is a potential complication after breast augmentation surgery. The term "mal-position" means "out of the correct position." The implants may have been placed incorrectly during the augmentation surgery, or another type of mistake may have been made during the surgery, or the implants (one or both) may move out of place over time.

Four Types of Implant Mal-position

There are four general categories of implant mal-position. These are when the implants have moved:

  • superiorly; i.e., the implants are "riding high"
  • inferiorly, or when they're "bottoming out"
  • medially, or toward the body's midline; this is called "symmastia," also known as "uni-boob"
  • laterally, or outward away from the body's midline

Each of these types of mal-positioning is visibly evident and often uncomfortable for the woman. Fortunately, essentially any instance of breast implant mal-position can be corrected.

High-Riding Breast Implants

If the breasts are positioned too high on the body even after settling post-surgery, the mal-positioning may be due to the formation of scar tissue that is squeezing the implants upward. This is uncommon, but it can be uncomfortable and can certainly look unnatural. To correct the position of implants that have moved in a superior direction, the implants can be taken out and the scar tissue can be reduced. Breast Implants can then be inserted again, leaving the breasts in a natural position.

Implants that Are Bottoming Out

Here, the implants have moved southward, and the nipple and areola are up toward the top of the fullness of the breasts, rather than centered at the front of the breasts. The distance from the nipple/areola to the fold under the breast (the inframammary fold) is also too large.

This type of inferior mal-position can be corrected by changing the inframammary fold, using internal sutures. The breasts will no longer be too full at the bottom, and the nipples will face forward.

Symmastia: �Uni-Boob�

Although the term "uni-boob" is humorous, there's not much to laugh about when a woman's breast implants are migrating toward the center of her body, perhaps even touching over the midline. Sometimes the cause of this migration is the inadvertent cutting of the horizontal muscle that connects to the sternum, during the original implant surgery.

Symmastia may also be caused by an overly aggressive surgery aimed at increasing the patient's cleavage, or by using too-large implants on a thin patient. Symmastia can happen whether the implants are placed over or under the chest muscle.

Correcting symmastia involves using internal sutures on the capsules around the implants to move them outward (laterally) to a better position. Special post-surgery dressings and a "thong bra" may be used to help stabilize the implants after a symmastia reconstruction.

Implants That Have Moved Laterally (Outward)

Here, one or both breast implants have moved toward the sides of the body. This can be corrected with internal sutures that decrease the size of the implant pockets, moving the implants toward the body's midline. The breasts will thus be placed naturally in the front of the patient's body.

A Combination of Mal-position Problems

For some women, the implant mal-position involves more than one of the four categories. For example, breast implants may be both "bottoming out" and mal-positioned laterally. However, combination mal-positioning can also be corrected. Some board-certified plastic surgeons specialize in the correction of mal-positioned breast implants; they are very skilled at revising the position of implants to achieve a natural look that is comfortable and permanent.