Precapsular Pocket Repositioning: An Effective Technique for Correcting Implant Malposition in Revision Breast Augmentation.

Abstract

Background: Breast augmentation remains one of the most commonly performed cosmetic procedures worldwide. However, the reoperation rate following mammoplasty reaches up to 36%, with implant malposition being a major cause of revision surgery. Implant displacement from its intended position often necessitates corrective intervention to restore aesthetic balance. Surgical correction typically involves modifying the existing pocket or creating a new one. Despite advancements in various techniques, challenges remain in ensuring reliability, precision, and surgical simplicity. This study evaluates the use of the precapsular space to create a new pocket for correcting implant malposition.

Methods: Between December 2015 and August 2024, 29 patients (52 breasts) underwent revision breast augmentation utilizing the precapsular implant repositioning technique. All patients had previously undergone breast augmentation with implants and subsequently developed implant malposition. A neoprecapsular pocket was created above the anterior capsule wall to ensure precise implant positioning. Surgical outcomes were assessed based on symptom resolution, patient satisfaction, and postoperative complications. Clinical outcomes and patient-reported satisfaction were measured using BREAST-Q scores.

Results: The mean patient age was 28.8 years (range: 25-37), with an average follow-up of 7.9 months. Implant malposition was successfully corrected in all cases without postoperative complications, including capsular contracture, breast asymmetry, and symmastia. BREAST-Q results demonstrated high patient satisfaction, with significant improvements in breast appearance and symmetry achieved without an increased risk of complications.

Conclusions: The precapsular pocket technique offers an effective solution for correcting implant malposition following breast augmentation. This method provides favorable aesthetic outcomes with high patient satisfaction and minimal complications, making it a promising approach for revision breast surgery.

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