title: Techniques to Repair Implant Malposition after Breast Augmentation: A Review.
abstract: BACKGROUND
  Implant malposition is a complication of breast augmentation that adversely affects aesthetic outcomes. It is one of the most common reasons for revisionary aesthetic breast surgery yet there is a lack of peer reviewed literature dedicated to the management of this complication.
  
  
  OBJECTIVE
  The purpose of this article was to summarize the malposition literature, review the types and causes of this complication, and evaluate the strengths and weakness of procedures aimed at addressing it.
  
  
  METHODS
  A review of the literature was performed using the PubMed database. Articles describing surgical techniques for correction of implant malposition, as well as outcome data for patients undergoing revision with described techniques, were included. Articles describing revisionary surgery following breast reconstruction were excluded. A series of cases are presented to illustrate techniques discussed.
  
  
  RESULTS
  Search criteria resulted in 763 articles. Title and abstract review followed by application of inclusion and exclusion criteria resulted in a total of 21 clinical studies from 1988 to 2014 that were included in this review. All studies included in this study were of level IV or V evidence.
  
  
  CONCLUSIONS
  Despite the overall low level of evidence in the literature regarding secondary breast augmentation, a thorough understanding of the corrective techniques presented will allow surgeons to make the most informed judgments. Weighing the strengths and weakness of these surgical techniques in the context of each patient will allow surgeons to develop the most appropriate treatment strategy. LEVEL OF EVIDENCE 4: Therapeutic.
authors.affiliation: Dr Chopra is a Plastic Surgery Resident, Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital; and the Division of Plastic and Reconstructive Surgery, The University of Maryland, Baltimore, MD. Dr Gowda is a Plastic Surgery Research Fellow, Division of Plastic and Reconstructive Surgery, University of Maryland, Baltimore, MD. Drs Kwon and Eagan are Aesthetic Surgery Fellows and Dr Stevens is a Clinical Professor of Surgery, Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA.
authors.forename: Karan
authors.initials: K
authors.lastname: Chopra
authors.affiliation: Dr Chopra is a Plastic Surgery Resident, Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital; and the Division of Plastic and Reconstructive Surgery, The University of Maryland, Baltimore, MD. Dr Gowda is a Plastic Surgery Research Fellow, Division of Plastic and Reconstructive Surgery, University of Maryland, Baltimore, MD. Drs Kwon and Eagan are Aesthetic Surgery Fellows and Dr Stevens is a Clinical Professor of Surgery, Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA.
authors.forename: Arvind U
authors.initials: AU
authors.lastname: Gowda
authors.affiliation: Dr Chopra is a Plastic Surgery Resident, Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital; and the Division of Plastic and Reconstructive Surgery, The University of Maryland, Baltimore, MD. Dr Gowda is a Plastic Surgery Research Fellow, Division of Plastic and Reconstructive Surgery, University of Maryland, Baltimore, MD. Drs Kwon and Eagan are Aesthetic Surgery Fellows and Dr Stevens is a Clinical Professor of Surgery, Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA.
authors.forename: Edwin
authors.initials: E
authors.lastname: Kwon
authors.affiliation: Dr Chopra is a Plastic Surgery Resident, Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital; and the Division of Plastic and Reconstructive Surgery, The University of Maryland, Baltimore, MD. Dr Gowda is a Plastic Surgery Research Fellow, Division of Plastic and Reconstructive Surgery, University of Maryland, Baltimore, MD. Drs Kwon and Eagan are Aesthetic Surgery Fellows and Dr Stevens is a Clinical Professor of Surgery, Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Eagan
authors.affiliation: Dr Chopra is a Plastic Surgery Resident, Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital; and the Division of Plastic and Reconstructive Surgery, The University of Maryland, Baltimore, MD. Dr Gowda is a Plastic Surgery Research Fellow, Division of Plastic and Reconstructive Surgery, University of Maryland, Baltimore, MD. Drs Kwon and Eagan are Aesthetic Surgery Fellows and Dr Stevens is a Clinical Professor of Surgery, Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA.
authors.forename: W
authors.initials: W
authors.lastname: Grant Stevens
mesh_terms: D019928:Breast Implantation / Q000009:adverse effects / Q000379:methods*; D018427:Breast Implants; D004954:Esthetics; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation