title: Treatment of breast animation deformity in implant-based reconstruction with pocket change to the subcutaneous position.
abstract: Breast animation may be an unfortunate result of subpectoral implant-based reconstruction following mastectomy. This article reviews a novel approach to the treatment of animation deformity in cases of reconstruction, whereby the pectoralis major muscle is sutured down to the chest wall and the implant is transferred to the subcutaneous plane. A retrospective review was performed on 19 breasts undergoing pocket change. In selected cases, fat grafting was added to augment the soft-tissue framework around the implant. Demographics, operative details, outcomes, and complications were recorded. All 19 breasts had complete resolution of their animation deformity. Complications were seen in five breasts (26.3 percent). Four breasts (21.1 percent) developed Baker grade III or IV capsular contracture requiring capsulectomy that was curative. One seroma (5.3 percent) required in-office drainage. There were no visible implant deformities, infections, or implant removals. In appropriately selected patients, pocket change to a subcutaneous plane is a safe and effective technique for correction of severe animation deformity following implant-based breast reconstruction.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Grand Rapids, Mich. From Partners in Plastic Surgery; and Grand Rapids Medical Education Partners.
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Hammond
authors.forename: William P
authors.initials: WP
authors.lastname: Schmitt
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D000368:Aged; D019928:Breast Implantation / Q000009:adverse effects* / Q000379:methods; D018427:Breast Implants; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057910:Implant Capsular Contracture / Q000503:physiopathology / Q000601:surgery*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome