Breast implants are a common choice for individuals seeking to enhance their breast size or shape. While generally safe and effective, an implant can sometimes shift or rotate from its intended position. This occurrence, known as implant flipping or malrotation, can lead to changes in breast appearance and comfort.
What Is Implant Flipping?
Breast implant flipping refers to the rotation or displacement of an implant within the surgical pocket. While not life-threatening, it can be cosmetically undesirable and cause discomfort.
Individuals might notice a change in breast shape, such as one breast appearing flatter or less projected, leading to asymmetry. The affected breast may also feel different to the touch, possibly firmer, softer, or lumpy. Discomfort or a heavy sensation can also occur.
Anatomical (teardrop-shaped) implants are more prone to noticeable flipping than round implants because their specific shape requires a particular orientation. If an anatomical implant rotates, the breast’s contour will distort significantly. Round implants, due to their symmetrical shape, may not show obvious visual changes even if they rotate, making flipping harder to detect without imaging. Textured implants are designed to adhere to surrounding tissue to reduce rotation, but they can flip if this adherence fails.
Common Causes of Implant Flipping
Several factors can contribute to a breast implant flipping. The size of the surgical pocket created during the initial procedure plays a significant role; if the pocket is too large, the implant has excessive room to move and rotate. The implant pocket should fit snugly to restrict movement.
Implant type and surface also influence the risk. Anatomical (teardrop) implants are more susceptible to noticeable rotation due to their asymmetrical design. Smooth-surfaced implants tend to move more freely than textured implants, which are designed to integrate with surrounding tissue and provide better stability. Even textured implants can flip if their adhesion to the tissue is insufficient or if issues like capsular contracture arise.
Capsular contracture, where scar tissue forms and tightens around the implant, can also cause flipping. If this scar tissue tightens unevenly, it can squeeze and distort the implant, forcing it to rotate. Physical trauma, such as accidents, sports injuries, or vigorous massage, can physically dislodge or rotate an implant. Insufficient post-operative rest and early strenuous activities can prevent proper implant fixation, increasing the risk of rotation.
For implants placed under the muscle (submuscular placement), strong pectoralis muscle contractions can cause movement or rotation. Less common factors include significant changes in body weight or the natural aging process, which can alter breast tissue and the implant pocket, potentially leading to increased implant movement and flipping.
Addressing a Flipped Implant
If a breast implant is suspected of flipping, consulting a board-certified plastic surgeon is the first step. The surgeon will typically diagnose a flipped implant through a physical examination, assessing the breasts for asymmetry or distorted shape. For round implants or when physical examination is inconclusive, imaging studies like ultrasound or MRI may confirm the implant’s exact position.
Once diagnosed, treatment options vary. A surgeon might attempt to manually rotate the implant back into place. This external manipulation may be considered if the implant flips occasionally. However, manual repositioning is often a temporary solution, as flipping may recur if the implant pocket is stretched.
Surgical correction, or revision surgery, is frequently the most definitive solution for a persistently flipped implant. This procedure often involves adjusting the implant pocket size for a more snug fit, limiting future movement. The surgeon might also remove or release any constricting scar tissue (capsulectomy) to allow the implant to sit properly. In some situations, the surgeon may recommend exchanging the current implant for a different type, such as a round or more textured implant, or even a different size, to reduce the likelihood of future flipping.
Minimizing the Risk of Flipping
Reducing the likelihood of breast implant flipping begins with careful planning and execution of the initial surgery. Selecting an experienced, board-certified plastic surgeon is important, as their expertise in creating an appropriately sized implant pocket and selecting the right implant type can significantly impact the outcome. A surgeon specializing in breast augmentation and revision surgery is often best suited to prevent complications like implant flipping.
A thorough discussion between the patient and surgeon about implant type and placement is beneficial. This includes whether a round or anatomical implant is more suitable, the choice between smooth or textured surfaces, and the implant’s placement (e.g., subglandular or submuscular) based on the patient’s anatomy and desired outcome.
Following all post-operative care instructions diligently is important for proper healing and implant stabilization. This includes wearing compression garments as advised, avoiding strenuous activities that could dislodge the implant, adhering to guidelines regarding massage techniques, and ensuring sufficient rest after surgery for proper implant fixation.
Long-term monitoring of breast implants is also part of comprehensive care. Regular check-ups with the surgeon allow for early detection of any issues, including subtle changes in breast shape or feel that might indicate implant movement. For silicone implants, the FDA recommends imaging such as ultrasound or MRI after 5-6 years post-surgery, and then every 2-3 years, to monitor for potential issues like silent ruptures or malposition.