What could have caused previous breast malposition and should I be concerned about this reoccuring after a revision?

You did not post photos, but I suspect your implants are much too large and heavy for your frame and tissue. You need to go smaller, have the pockets tightened laterally with internal sutures, and may need mesh.

Hi LulaPayne! It depends on how the implants are malpositioned. 600 cc implants are quite large and heavy. They put weight on the inframammary fold and cause the implants to move lower on the chest wall. In order to correct this, we often have to place a mesh to reinforce the soft tissue and provide support to the implant. If they are sitting high on the chest wall, this can be due to a capsular contracture. If implants are displacing laterally (into the armpit), this can be from activation of the pectoralis muscle if they are below the muscle, or over-dissection of the lateral pocket. A pocket revision with sutures or mesh is necessary in this instance. Hope this helps!