Prospective Two-Year Cohort Study of Surgical and Implant Predictors of Breast Implant Displacement and Rotation After Aesthetic Augmentation

Participants will be enrolled before aesthetic breast implantation. A standardized preoperative anatomic assessment and detailed operative record will establish implant and pocket characteristics. Postoperative month 1 will serve as the reference position after early swelling decreases, and assessments will be repeated through years. A locked landmark-based definition will distinguish clinically significant inferior, superior, medial, and lateral displacement and rotation. Time-to-event and mixed-effects models will evaluate implant, surgical, and patient predictors while accounting for bilateral implants.

Inclusion criteria

• Female sex and age 18 years or older.
• Primary or revision aesthetic breast implantation with a permanent implant.
• Complete documentation of pocket plane, incision route, texture, shape, volume, laterality, and operative pocket measurements.
• Standardized early postoperative baseline photography and clinical position assessment.
• Ability to complete follow-up through 24 months.
• Written informed consent.

Exclusion criteria

• Reconstructive implantation after mastectomy or major trauma.
• Tissue expander.
• Immediate major postoperative complication requiring implant removal before the position baseline can be established; these cases remain in safety reporting but not the position-risk cohort.
• Missing operative or device variables.
• Inability to obtain standardized photographs or position measurements.
• Planned pregnancy during the first 12 months if the final protocol elects to exclude it.