5 Breast Implant Animation: Prevalence, Predictors and Current Concepts for Treatment
Breast augmentation is the most common aesthetic procedure performed on women in the United States. The retropectoral pocket for breast augmentation has become a very popular technique due to it’s many advantages. Breast implant animation has been reported sporadically but there is a paucity of data regarding this phenomenon. The goal of this survey is to assess the prevalence of breast animation as reported by aesthetic plastic surgeons following retropectoral breast augmentation and the treatment options utilized to improve this phenomenon.
Methods/Technique:
A survey instrument was designed for practicing aesthetic plastic surgeons, administered using survey monkey. The survey consisted of 10 questions regarding preferred surgical technique for breast augmentation, prevalence of implant animation, preferred treatment and possible predictors of who will experience implant animation. The survey was distributed to American Society of Aesthetic Plastic Surgery members via a link in the organizations monthly e-newsletter.
Results/Complications:
Forty seven members replied to the mailing. Most repondents were experienced surgeons with thirty-six (76.6%) being in practice greater than 15 years. Twenty-six (55.3%) surgeons perform greater than 51 breast augmentations per year, with 11 (23.4%) which perform more than 100 per year. The retropectoral pocket is used by 35 (79.5%). Almost all of the respondents experienced implant animation using the retropectoral pocket (n=42, 89.4%). Twenty surgeons (42.5%) believe that greater than 20% of patients in their practice experience implant animation; however, most surgeons (n=44, 93.6%) report that less than 20% of these patients present with implant animation as a concern. The most common surgical intervention to address this problem is change from retropectoral to a subglandular pocket. To avoid implant animation when using the retropectoral pocket, fourteen surgeons (35%) release the pectoralis major muscle completely from its caudal insertion, eleven surgeons (27.5%) use a dual plane technique to release the breast parenchyma from the pectoralis major muscle and fifteen surgeons (37.5%) do not change their surgical technique to prevent implant animation. Most people have not yet found a way to predict which patients will experience breast implant animation; however, some suggest there are predictors: athletic build, low insertion of pectoralis major muscle, and high inframammary fold. Inadequate release of the pectoralis major muscle was an iatrogenic technical consideration that was mentioned.
Conclusion:
Breast implant animation is a known sequelae of retropectoral breast augmentation. There is no consensus on surgical methods that can be used to consistently prevent implant animation. Most surgeons changed the breast implant pocket from retropectoral to subglandular when surgical intervention was desired to correct this condition. There are multiple theories regarding possible anatomic variants that may predict the development of implant animation, but further study is needed in order to validate these theories.