Implant displacement is a common complication of breast augmentation. The implants are displaced toward the axilla when the patient is lying down on the table.. For the surgical plan, whenever you have this issue, you have to create a new breast pocket that will fit the implant and avoid displacement of the implant in any direction. Since she had implants above the muscle, it is more favorable to create a pocket under the muscle. This pocket needs to be done precisely to avoid shifting of the implant from the new pocket below the muscle to the pocket that is above the muscle.
Many times there is noticeable excess skin and some sagginess of the breasts, and a breast lift and excision of excessive skin, which is also contributing to the displacement of the implants to the side because the skin was stretched by the placement of her previous breast implants. I perform an incision around the areola, and dissect all the way until the implant is identified. Subsequently, the muscle is cut at the bottom and a pocket is dissected superiorly, making sure that the implant will fit in the new pocket space perfectly. Once the implant is placed in the submuscular plane, we are going to inflate the saline implant until the appropriate breast volume is achieved. I am also going to suture-suspend the implant to avoid displacement of the implant from the submuscular plane to her old subcutaneous plane. Once the implant has been placed, I am going to tailor tag the excess skin, remove the skin, and then use strong sutures to avoid areola widening and close the periareolar incision. The same procedure was performed on the left breast.