Feeling an implant move can be highly unsettling, immediately triggering concern about the integrity and placement of a device meant to be stable within the body. This sensation requires prompt and professional medical evaluation to determine if the movement represents a normal settling process or a genuine complication. An implant is a medical device intentionally placed inside the body, ranging from cosmetic prostheses to functional devices like birth control rods.
Defining Implant Migration and Displacement
The feeling of movement often relates to two distinct medical concepts: displacement or migration. Displacement describes an implant shifting from its intended surgical pocket, usually remaining within the immediate area. For breast implants, this can manifest as a rotation, a lateral shift toward the armpit, or “bottoming out,” where the implant drops below the natural crease of the breast. These shifts result in noticeable changes to the shape or symmetry of the surrounding tissue.
Migration, in contrast, involves the implant traveling a greater distance from the original surgical site, potentially moving to an adjacent anatomical space. For contraceptive implants, such as those placed in the upper arm, migration is defined as movement of two centimeters or more beyond the insertion point. A migrated contraceptive implant might be felt traveling down the arm, sometimes becoming non-palpable and requiring imaging for localization.
Underlying Causes of Implant Movement
Movement often stems from issues related to the implant pocket or the body’s reaction to the device. A primary cause of displacement is the implant pocket being either created too large during surgery or stretching over time, which allows the device to shift, particularly in the case of smooth-shelled breast implants. Conversely, another common cause is capsular contracture, where the body’s natural scar tissue capsule around the implant thickens and tightens. This hardening can squeeze and distort the implant, forcing it into an abnormal or painful position.
Capsular contracture is increasingly linked to the formation of a bacterial biofilm on the implant surface, which triggers a chronic immune response. Additionally, capsular weakness occurs when the surrounding tissue is too lax, allowing gravity and muscle activity to pull the implant laterally or downward. External forces, such as severe, direct trauma or engaging in excessive physical activity before the implant pocket has fully healed, can also disrupt the surgical site and cause an implant to shift.
In the context of dental implants, movement of the titanium screw itself often indicates a failure of osseointegration, which is the process where the bone fuses directly with the implant surface. This lack of integration can be caused by underlying infection, excessive mechanical stress, or inadequate bone density at the time of placement. If only the dental crown or abutment feels loose, it is usually a simpler mechanical issue unrelated to the implant’s stability in the jawbone.
Immediate Steps and When to Seek Urgent Care
The most immediate step upon noticing a change is to avoid manipulating or attempting to manually reposition the implant, as this could worsen the situation. Instead, you should carefully note the exact location of the sensation, when the movement was first observed, and whether it is accompanied by any other symptoms. The next step is to contact the healthcare provider who performed the implantation or a relevant specialist to schedule an evaluation.
Certain signs should prompt an immediate and urgent consultation, bypassing a routine appointment schedule. These “red flags” include any sign of infection, such as fever, rapid swelling, or the presence of pus or foul discharge around the surgical site. Severe or rapidly increasing pain, skin compromise, or a sudden, dramatic shift in the implant’s position are also reasons to seek urgent medical attention.
During the medical evaluation, the provider will perform a physical examination to assess the implant’s position and the condition of the surrounding tissue. To accurately confirm the location and rule out complications, the assessment will likely involve medical imaging. Diagnostic tools such as ultrasound, X-ray, or Magnetic Resonance Imaging (MRI) are commonly used to visualize the implant and the integrity of the pocket or capsule.
Clinical Treatment Options for Repositioning or Removal
Once the movement is confirmed and the cause identified, the treatment approach will be tailored to the specific problem. For minor shifts or expected post-operative settling, the medical team may recommend a period of observation, which involves monitoring the implant over time without immediate intervention. If the displacement is aesthetic and not medically compromising, the patient and surgeon may decide to simply monitor the situation.
If the movement is problematic, non-surgical maneuvers, such as closed manipulation, are sometimes attempted to manually reposition the device. However, this method is rarely a definitive long-term solution for severe displacement. For a true correction, surgical revision is often necessary. This procedure may involve a capsulorrhaphy, where the surgeon tightens the stretched implant pocket to restrict movement and secure the device in the correct anatomical location.
In cases of capsular contracture, a capsulectomy is performed, which involves surgically removing the hardened scar tissue capsule that is constricting and displacing the implant. Ultimately, if the device is damaged, infected, or severely malpositioned, the treatment may require the full removal of the implant, known as explantation. Following removal, a new implant may be placed, or the area may be reconstructed using techniques like fat grafting or a tissue lift.