Breast Implant Malposition: Prevention, Assessment, and Treatment

Breast implant malposition is a common, multifactorial complication and a leading contributor to reoperation in breast surgery. Malpositions may be unidirectional or multidirectional and can occur in inferior, medial, lateral, superior, or rotational directions. Contributing factors include, but are not limited to, surgical technique, patient anatomy, implant characteristics, capsular contracture, and age-related changes in the implant and breast tissue. Prevention may be supported through tissue-based planning, appropriate implant selection, and precise pocket design. When revision is required, a staged, algorithm-informed approach is recommended. The only guaranteed cure for malposition is no implants.