Rotation of microtextured anatomical breast implants: A retrospective series of 134 reconstructions.

Background: Anatomically shaped breast implants are widely used in implant-based breast reconstruction because of their ability to restore breast contour and projection. Following regulatory restrictions on macrotextured implants, microtextured anatomical implants have emerged as an alternative. However, concerns remain regarding their positional stability, particularly the risk of implant rotation. Methods: We conducted a retrospective review of patients who underwent immediate or delayed implant-based breast reconstruction using microtextured anatomical breast implants between December 2020 and October 2025. All procedures were performed by a single experienced plastic surgeon. Implant rotation and postoperative complications were recorded. Outcomes were analysed on a per-patient basis. Results: A total of 134 breast reconstructions were performed in 100 patients, with a mean follow-up of 15.5 months. Four cases of implant rotation occurred in four patients, resulting in an overall rotation rate of 4%. Implant rotation was observed exclusively in revision procedures or during second-stage reconstruction. Three cases were successfully managed by external manipulation, and one required surgical revision. Other complication rates were consistent with those reported in the literature. Conclusion: In this retrospective series, the microtextured anatomical breast implants used in the study, characterized by ultra-low surface roughness, were associated with a low rate of clinically detectable rotation in implant-based breast reconstruction. When combined with meticulous surgical technique and appropriate pocket management, satisfactory positional stability was observed in this cohort.