Understanding Implant Mobility
Movement in a breast implant can be a source of concern. While some degree of implant mobility is natural, understanding its nuances is important.
Breast implants exhibit varying degrees of movement depending on their placement. Implants placed under the breast tissue (subglandular) tend to have more natural movement as they are positioned directly over the chest muscle. Conversely, implants placed beneath the chest muscle (submuscular) generally have less independent movement due to the muscle’s stabilizing effect. Normal implant mobility involves a subtle shift with changes in body position or muscle contraction, maintaining a symmetrical appearance. This movement is typically not accompanied by pain or noticeable changes in breast shape. However, movement that is excessive, sudden, or causes discomfort may indicate a deviation from this normal range, warranting further evaluation.
Reasons for Implant Movement
Several factors can contribute to breast implant movement. One common reason is normal settling after surgery. Over weeks and months, implants can subtly descend into their final position as gravity and tissue relaxation take effect.
A significant cause of movement can be capsular contracture, where scar tissue forms a tight capsule around the implant. This capsule can contract, compressing the implant and causing it to shift, harden, or distort the breast’s shape.
Implant displacement or malposition occurs when the implant shifts significantly from its intended surgical pocket. This can manifest as the implant moving too high (superior), too low (inferior), or to the side (lateral). Factors contributing to malposition include an inadequately sized or dissected surgical pocket, insufficient support from surrounding tissues, or excessive post-operative activity before healing is complete. Trauma or injury to the chest area can also forcefully dislodge an implant.
An implant rupture can also lead to perceived changes in breast shape or feel. In cases of silicone implant rupture, the gel may remain contained within the scar capsule, but a loss of implant volume can alter the breast’s contour. Saline implant ruptures result in rapid deflation, leading to a noticeable change in breast size and shape. Long-term effects of age and gravity on breast tissue can also influence implant position over many years.
When to Seek Medical Advice
A sudden or significant change in implant position should prompt a consultation with a healthcare provider, especially if the implant visibly shifts to a new location (e.g., higher, lower, or to one side).
Pain, tenderness, or discomfort associated with the implant movement are important indicators to seek medical advice. While some minor soreness might be present during normal settling, persistent or increasing pain suggests an underlying issue. Any noticeable changes in breast shape, size, or symmetry that accompany the movement should also be evaluated. For example, if one breast appears significantly different from the other due to implant shift, it warrants a professional assessment.
Hardening or firmness of the breast suggests possible capsular contracture. Other warning signs include redness, swelling, or warmth in the breast area, which could indicate an infection. Visible rippling, wrinkling, or creasing of the breast skin can also signal an issue with the implant or its position. Additionally, hearing unusual sounds, such as sloshing or squeaking noises from the breast, should be discussed with a medical professional.
Diagnosis and Management of Implant Movement
The diagnostic process typically begins with a thorough physical examination. A healthcare provider, often a plastic surgeon, will visually assess the breasts for symmetry, shape, and position of the implants. They will also manually palpate the breasts to evaluate tissue consistency, identify any areas of firmness or tenderness, and determine the implant’s current location and mobility.
Following the physical examination, imaging studies are often utilized to gain a more detailed view. A mammogram provides general information about breast tissue and implant integrity. Ultrasound imaging is useful for evaluating implant shell integrity, detecting fluid collections, and assessing the scar capsule. In some cases, a magnetic resonance imaging (MRI) scan may be recommended, as it offers the most comprehensive view of silicone implant integrity and can identify subtle ruptures or other abnormalities.
Management depends on the underlying cause identified through diagnosis. For minor, non-symptomatic movement, such as slight post-operative settling, observation may be the primary approach. For minor malposition, non-surgical interventions like specific breast massage techniques or specialized supportive bras might be suggested. More significant issues often require surgical correction.
Surgical interventions include capsulectomy, where the tightened scar capsule is removed to address capsular contracture. For implant malposition, surgical repositioning or revision of the surgical pocket may stabilize the implant. If an implant rupture is confirmed, surgical removal and potential replacement are recommended. Consult a board-certified plastic surgeon for proper diagnosis and a personalized treatment plan.