Rotation of anatomic prostheses: a possible cause of breast deformity

Background: anatomical prosthesis rotation is considered an exceptional event and is scarcely discussed in the scientific literature. A recent work by Baeke roused the suspect that it could be more frequent then expected. Methods: a retrospective study was performed to find out the prevalence of such an adverse event, taking into account the patients operated on by us and the ones receiving revision surgery because of major adverse events with anatomical prostheses. Results: five patients having a total number of 6 rotated anatomical prostheses were observed in the last five years. The prevalence of this adverse event was 1.5% among the patients operated on by us. But it dramatically raised to 12.2% when considering revision surgeries for anatomical prosthesis major failures. Conclusions: anatomical prosthesis rotation prevalence could be higher than expected, and the patients should be aware of such a risk. Tendency to rotate could be linked to the prosthetic geometrical features, and eased by some local conditions such as the leak of adherence due to a double capsule, a peri-prosthetic mesh, or a mismatch between the prosthesis and its pocket.