Augmentation mammaplasty: where should the implant be placed?

Malposition of the prosthesis is one complication of augmentation mammaplasty. The most projected point of the prosthesis should be placed just behind the nipple to create a natural-looking breast. However, in some cases, when a textured surface cohesive silicone gel prosthesis with an inframammary approach is used, low displacement of the prosthesis is encountered within 1 year. This phenomenon can be seen both in subpectoral augmentation with severing of the muscle at the level of the inframammary fold and in subglandular augmentation when the patient's breast and skin are very soft and easily stretchable. Therefore, the elasticity of the breast should be evaluated before surgery. If the patients breast and skin are very soft and easily stretchable, the pocket for the prosthesis should be created 1 to 1.5 cm superiorly to the usual pocket for the prosthesis. The design of the pocket for the prosthesis should be different depending on the shape of the prosthesis and the elasticity of the patient's breasts.