The jumping breast phenomenon is well known in cosmetic surgery but there is hardly any literature about it. In oncological breast surgery, the problem has even been mostly ignored so far, although the deformation of the breast is sometimes serious and the patients suffer considerably from it.
The jumping breast phenomenon is a complication resulting from a subcutaneous mastectomy when a subpectoral implant is inserted after the removal of breast tissue. In this phenomenon, wrinkles and ripples appear on a breast under contraction of the pectoral muscle, which are accompanied by an elevation of the nipple-areolar complex of up to five centimetres in some cases and deformation of the upper and/or lower quadrant. Slender patients with a thinner subcutaneous fat layer are particularly affected.
Recently, for the first time, a distinction was made between three degrees of severity of the phenomenon. If the patient suffers from the phenomenon, the severity must always be evaluated with at least two.
Severity I: Wrinkles or ripples on one breast compared to the other without affecting the shape of the upper quadrant, possibly with elevation of the nipple-areolar complex (caudal quadrant jumping breast).
Severity II: Clear formation of wrinkles and ripples of the skin in the upper inner quadrant, possibly with elevation of the nipple-areolar complex (cranial quadrant jumping breast)
Severity III: Phenomenon occurs in both cranial and caudal form, possibly with elevation of the nipple-areolar complex.
A possible solution to avoid the jumping-breast phenomenon is a change of approach: Instead of the usual subpectoral implant pocket, the epipectoral implant pocket was tested. According to the latest research results, more than 50 percent of patients were satisfied with this pocket after the first operation. A change in the position of the implant from subpectoral to epipectoral after the first operation also proved possible for patients who had already experienced problems, despite the severity of a second operation.
If wrinkling or protrusion of the implant margins is observed as a result of a prepectoral insertion of the implant, which occurs more frequently in very slim patients in particular, a change of position from pre- to subpectoral can be performed in a second step after completion of the wound healing process without any problems, thus considerably reducing the risk of the jumping breast phenomenon.
Source: Sherko Kümmel: How to Avoid the Jumping Breast Phenomenon After Implant Reconstruction, Lecture, 10th International Charité Mayo Conference, Berlin, 03.04.2019