PLASTIC30 Apr Correcting Breast Implant Malposition with Revision Surgery
Breast implant malposition is a recognized complication of breast augmentation in which implants shift from their intended position within the chest. While primary augmentation aims to create symmetrical projection and balanced breast contours, various factors can lead to displacement over time. Revision surgery is required to restore alignment, proportion, and structural stability.
Implant malposition can occur in several directions. Lateral displacement causes implants to drift toward the armpits, particularly noticeable when lying down. Medial malposition, sometimes referred to as symmastia, results in implants migrating too close together across the midline. Inferior displacement leads to implants sitting too low on the chest, while superior malposition places implants unnaturally high.
Causes vary. Over-dissection of the implant pocket during primary surgery can create excessive space, allowing implants to migrate. Weak tissue support, gravity, implant weight, or trauma may also contribute. In some cases, capsular contracture alters implant positioning through asymmetric scar tightening.
Correction requires precise surgical planning. Pocket revision is the cornerstone of treatment. Surgeons may close portions of the existing pocket using internal sutures to reposition the implant more centrally. Alternatively, a new implant pocket may be created to achieve improved alignment.
In complex cases, reinforcement materials such as acellular dermal matrices (ADM) may be used to strengthen tissue support and prevent recurrence. Implant exchange may also be recommended if size or weight contributed to displacement.
At PHI Surgery in Montreal, Dr. Perry Gdalevitch evaluates implant position, capsule integrity, and soft tissue strength before designing a revision plan. The objective is not only to reposition the implant but to restore stable long-term support.
Recovery mirrors revision augmentation timelines, with swelling resolving over weeks and final positioning settling over several months.
Implant malposition correction restores both structural balance and aesthetic harmony — helping patients regain confidence in their surgical outcome.
