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Implant Complications: Implant Rotation and Waterfall Deformities

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Abstract

Rotation of breast implants is a problem that relates to anatomically shaped form stable implants as low cohesive, non-form stable implant can rotate freely without giving any deformities of the breast. There are clear and good indication for the use of anatomically shaped implants in spite of this potential problem. Rotation of implants is a subset of implant malposition as malposition also can be inferior, lateral, medial, all of which creates deformities and poor outcomes after breast augmentation surgery.

Early implant malposition frequently depends on poor preoperative planning and/or surgical technique. Over-dissection of the implant pocket and poor positioning horizontally or vertically on the chest wall can produce different type of initial implant malposition including rotation. These problems should be avoided with the use of a meticulous preoperative planning and surgical technique. If implant malposition occurs late, after primary uneventful healing, this frequently relates to the tissue-implant interaction and the degree of capsular formation. Several different treatment alternatives must be considered when treating implant rotation.

In the waterfall deformity an implant is too high positioned in relation to the nipple areola complex, where lax breast tissue hangs like a waterfall on top of the implant. To avoid this complication a meticulous preoperative implant selection and planning is of paramount importance. The implant has to be positioned correctly vertically on the chest wall in relation to the nipple areola complex, and the skin between the nipple areola complex and postoperative inframammary must be analysed to see that it is adequately filled by the implant.

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Authors and Affiliations

  1. Karolinska Institute, Stockholm, Sweden

    Per Hedén

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  1. Per Hedén
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Correspondence to Per Hedén .

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Editors and Affiliations

  1. Department of Plastic Surgery, National Institute for Cancer, “Regina Elena”, Rome, Italy

    Roy de Vita

1 Electronic Supplementary Material

The neo-submsuculasr pocket technique used in Fig. 5a–c. Capsular contracture L breast relating to a double capsule formation of a macrotextured implant. A small partial attachment between the double-capsule inner layer and the outer layer prevented rotation. Without such attachment a rotation of this inner capsule gliding surface would likely also occur (MOV 106708 kb)

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Hedén, P. (2022). Implant Complications: Implant Rotation and Waterfall Deformities. In: de Vita, R. (eds) Aesthetic Breast Augmentation Revision Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-86793-5_4

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  • DOI: https://doi.org/10.1007/978-3-030-86793-5_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-86792-8

  • Online ISBN: 978-3-030-86793-5

  • eBook Packages: MedicineMedicine (R0)

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