Prevention and treatment of horizontal malposition of implants (telemastia and synmastia) after breast augmentation

Objective . Implant malposition is a common complication after augmentation mammoplasty and ranks second among the reasons for revision surgery after capsular contracture. Improperly positioned implants are not only aesthetically unattractive but can also negatively affect the psychological state and quality of life of patients. Purpose of a study: to analyze current trends in the prevention and management of lateral or medial implant displacement following augmentation mammoplasty. Material and Methods . A literature search was conducted in the PubMed and Google Scholar databases for English-language articles published over the past 10 years on the topic of “Prevention and management of horizontal implant malposition.” Included in the analysis were clinical studies, case reports, and case series specifically addressing this issue. Brief communications, letters to the editor, reviews, meta-analyses, and experimental studies were excluded. The search strategy utilized the terms “lateral displacement” and “symmastia after augmentation mammoplasty,” as well as their synonyms and related combinations. Results and Discussion . Using the keywords “lateral displacement” and “symmastia after augmentation mammoplasty,” along with relevant synonyms and alternative phrases, a total of 748 articles were initially identified. After removing 72 duplicates during the preliminary screening, titles were reviewed and inclusion and exclusion criteria were applied, resulting in the exclusion of 608 additional publications. Following full-text assessment of the remaining 68 articles, only 6 met the criteria for final analysis. Horizontal implant malposition is a relatively rare and underexplored complication of breast augmentation surgery. The studies selected for final analysis addressed both lateral and medial implant displacement in the broader context of implant malpositions, including superior and inferior displacement. Conclusion . The primary strategy for preventing lateral and medial implant displacement is careful surgical planning based on each patient’s individual anatomical characteristics. Other important factors include implant size, preservation of natural folds and fascial structures, adherence to proper surgical technique, and appropriate pocket selection. For the treatment of lateral implant displacement, the reviewed literature recommends capsulorrhaphy and the use of biological or synthetic meshes.