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Treatment of Breast Animation Deformity in Implant-Based Reconstruction with Pocket Change to the Subcutaneous Position

Hammond, Dennis C. M.D.; Schmitt, William P. M.D.; O’Connor, Elizabeth A. M.D.

Plastic and Reconstructive Surgery: June 2015 - Volume 135 - Issue 6 - p 1540–1544
doi: 10.1097/PRS.0000000000001277
Breast: Ideas and Innovations
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Summary: Breast animation may be an unfortunate result of subpectoral implant-based reconstruction following mastectomy. This article reviews a novel approach to the treatment of animation deformity in cases of reconstruction, whereby the pectoralis major muscle is sutured down to the chest wall and the implant is transferred to the subcutaneous plane. A retrospective review was performed on 19 breasts undergoing pocket change. In selected cases, fat grafting was added to augment the soft-tissue framework around the implant. Demographics, operative details, outcomes, and complications were recorded. All 19 breasts had complete resolution of their animation deformity. Complications were seen in five breasts (26.3 percent). Four breasts (21.1 percent) developed Baker grade III or IV capsular contracture requiring capsulectomy that was curative. One seroma (5.3 percent) required in-office drainage. There were no visible implant deformities, infections, or implant removals. In appropriately selected patients, pocket change to a subcutaneous plane is a safe and effective technique for correction of severe animation deformity following implant-based breast reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Grand Rapids, Mich.

From Partners in Plastic Surgery; and Grand Rapids Medical Education Partners.

Received for publication July 25, 2014; accepted January 5, 2015.

This project has been approved by the Institutional Review Boards at Spectrum Health.

Disclosures: The authors have no financial interest to declare in relation to the content of this article.

Dennis C. Hammond, M.D., Partners in Plastic Surgery, 4070 Lake Drive SE, Suite 202, Grand Rapids, Mich. 49546, hammonddc@aol.com

©2015American Society of Plastic Surgeons