Quantitative assessment of the breast implant malposition after augmentation mammaplasty

Abstract

Slight displacement of breast implants from initial positioning is expected and inherent in submuscular augmentation mammoplasty (SAMP). However, due to various factors, displacement of implants can progress, causing discomfort, changes in the shape of the breast, and deterioration of aesthetics. The boundary between normality and pathology in the case of displacement of the mammary glands (MG) implants is currently unclear due to various reasons, including the lack of a quantitative measure of its assessment. Objective — to develop a quantitative assessment of breast implant malposition (BIM) and to determine its one‑year frequency within a year after SAMP. Materials and methods. The study included 112 women who underwent SAMP for hypomastia in the period from 2020 to 2022 at the Bogomolets National Medical University. The average age was 34.1±6.7 years, body mass index — 20.4±1.8 kg/m2; 78 (69.6%) women had a history of pregnancy and childbirth, and 75 (67.0%) were breastfeeding. Round prostheses with a smooth surface were implanted in all patients. The value of BIM was evaluated one year after SAMP according to the developed method as a percentage of the increase in the area of the non‑ossified area in relation to the area of the prosthesis. Results. In all women, there was a 7.94.5% (from 1.5% to 34.5%) displacement of the implants from their initial location in all MG. Among the vectors of BIM, lower‑lateral ones prevailed — 124 (55.4%) MG compared to 53 (28.6%) upper‑lateral ones, p=0.001. Lower 18 (8.0%) and upper‑lateral at 150° — 11 (4.9%) BIM were the least common. Symmetrical matching of prosthesis movement vectors in both MGs was observed in 75 (67.0%) women; in 37 (33.0%), they were different. The same values of BIM in both MGs were observed in 54 (48.2%) women. In other cases, the values of BIM were greater in the right MG — 40 (35.7%) or in the left MG — 18 (16.1%). Cluster analysis classified the displacement of implants into 4 degrees: the first — from 1.5% to 6.4%, the second — from 6.5% to 10.4%, the third — from 10.5% to 20.0%, and the fourth >20.0%. Conclusions. Using smooth‑surfaced, round implants, the displacement of all implants from their initial site was shown to be 7.9±4.5% one year following SAMP.