Rotation of Anatomical Implants: A Single Surgeon's Experience of over 1500 Patients

Breast augmentation may be performed using round or anatomical shaped implants, and since their introduction in 1993, the indications and outcomes of anatomical implants have been under scrutiny. In fact, due to their asymmetric shape, these devices have a unique risk of rotation. We have previously described our indications and rationale for using anatomical implants as well as a discussion of surface textures and BIA-ALCL. In this review, we primarily address our experience of dealing with clinically evident rotation. All consecutive female patients operated for primary breast augmentation by the first author, who had anatomical implants and had at least 6 months follow-up, were included in this study. Of 1527 female patients operated, 1126 patients with 2252 breast implants met the inclusion criteria. The mean implant volume was 310.9 cc, and the mean follow-up was 18.8 months. 1.8% of implants (n = 41) were found to be clinically rotated at a mean of 14.9 months after surgery. A statistically significant higher incidence rate was found on the left side. Rotation of anatomical implants is often stated as a reason to avoid their use. Our data suggest that despite a short learning curve, it is not an insurmountable problem and with attention to the etiology, its incidence can be consistently minimized.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .