Do Implants Move or Change Shape After Pregnancy?

Question

I had breast augmentation, under the muscle, using saline smooth shelled implants 8 years ago.  I had a child three years ago and my implants are now visible through the skin with rippling and the left implant seems to have shifted slightly causing mild aching.  Does it sound like these need to be replaced or is this all normal?

Sanjay Grover, MD, FACS · Answer

A woman's breast will change following pregnancy and nursing and time alone. Following pregnancy and nursing, breast will enlarge and engorge, and then will atrophy or involute. This will leave the breast 'droopier' and thinner, and can cause the nipple to descend. If you are thin to start with and have little breast tissue, you will notice that you can feel the implant much more. This is especially common with saline implants where rippling can be noticed. You should visit your board-certified plastic surgeon to have him/her evaluate if you would benefit from an implant exchange to a high profile silicone implant with or without a lift.

David Shafer, MD, FACS · Answer

Jai,
Implants to not change with pregnancy.  However, your skin may change with pregnancy.  In response to the hormonal changes in your body during pregnancy, your skin responds just like all of the other parts of your body.
To this effect, the skin may be looser, thinner, etc.  You may need to have an adjustment surgery, but it is not due to the implants.  It is more likely due to your changing body.
Good luck with your surgery.

Jeffrey Weinzweig, MD, FACS · Answer

Pregnancy can cause many changes in the breast tissue and skin that can affect the look, feel, and positioning of the implant. The changes in the breast could be from skin elasticity change, weight gain/loss, and hormonal effects. A patient that is not satisfied with the way her current breasts look following pregnancy should speak with her plastic surgeon regarding options which might include mastopexy and implant exchange.

Tom J. Pousti, MD · Answer

Thank you for the question.

Breast implants do not necessarily change position or shape after pregnancy.

However, the overlying breast tissue and/or skin does often change. The exact change the specific patient will experience during or after pregnancy is not predictable. Some common changes seen with the breasts  after pregnancy include " involutional  hypoplasia" (breasts  become smaller)  and/or breast ptosis (" drooping"). The changes the breasts experience may be related to genetic factors, skin elasticity changes, hormonal effects, and/or weight gain/loss around the time of pregnancy.

The changes that the overlying breast tissue and/or skin undergo after pregnancy may  cause the breast implant to appear “changed” after the pregnancy. For example, if the patient loses breast tissue volume after pregnancy, the breast implant may become more exposed and the patient may feel (rippling)  or see the implant more so than before pregnancy.

I ask my  patients to follow up with me  approximately 3 months after they have stopped breast-feeding to evaluate the breasts  and the underlying breast implants.

I hope this helps.

Steven Wallach, MD · Answer

Rippling of the implant is more common in very thin patients with poor soft tissue coverage. Over filled salines may improve the rippling or possible exchange to silicone gel implants or even adding another layer of coverage such as Alloderm.

Jennifer L. Walden, MD · Answer

The breast tissue and skin itself changes after pregnancy because of the homonal fluctuations. After breast feeding the tissues involute and the skin is stretched and thinner.
I would advise waiting until about 6 months (or later depending upon your childcare situation) after the completion of breast feeding to undergo an exchange to siicone responsive gel implants, with or without a lift depending upon your anatomy.
Good luck,
Dr. Walden

Robin T.W. Yuan, MD · Answer

Anything can happen during pregnancy. Implants can get hard. Breast tissue can shrink or enlarge. The important question is: do your breasts look like what you would like them to and, if not, are you motivated enough to do something about them?
If you are satisfied, then you can leave them alone since cosmetic surgery is completely elective.  If you see things you do not like, visit a plastic surgeon and see what options you might have.

Francisco Canales, MD · Answer

Hello,
Pregnancy causes a great number of changes in a woman's body.  As the pregnancy progresses, the breasts and milk ducts enlarge in preparation for breast feeding.  Once the baby is born, the process of breast feeding causes a daliy filling and emptying of the breasts.  Once breast feeding stops, the breasts sometimes lose some of the firmness and actual size that they had before preganancy.
The end result can be a thinner envelope around your breast implants, which can now be palpated more easily than they could before pregnancy.  We find that to be especially true of saline implants and our Santa Rosa mommy makeovers many times involve trying to restore the breasts to their shape before pregnancy.
Your options are many: some women feel reassured that what they have experienced is normal and they do not need any surgery.  Others may feel that they liked their breasts before pregnancy and would like to restore them to that look and feel. If the implants were saline, you could change to a silicone gel implant, which may feel less noticeable under the thinner breast tissue.  If you prefer to keep the saline implants, then you could have  mastopexy (breast lift) to tighten the skin around the existing implants.
The final choice is yours. Be sure to discuss with your doctor whether you are planning more children in the future and exactly what you would like to achieve. Unfortunately, once breasts have gone through pregnancy and breast feeding, achieving the exact look of a "before pregnancy" breast is not possible.  They will still look good, but not the same as before pregnancy.
Good luck!

Scott E. Kasden, MD, FACS · Answer

The breast and implant may have indeed shifted downward as a result of the pregnancy and engorgement of the breasts.  After pregnancy, the breast tends to loose glandular tissue, and so there is less padding over the implant- ergo, you may now have ripples, and feel the implant.
You should not have pain, however.  This may be a sign of a contracture.
My advice is to check with your doctor.  The reasons to have surgery would be pain or dissatisfaction with the appearance.  Your surgeon will be the best person to help you evaluate the benefits and risks associated with your options.

Jeffrey Zwiren, MD · Answer

It is possible that two things are happening. Following a pregnancy some breasts lose volume making the implant more palpable. It is also possible that you have developed a degree of capsular contracture this may be causing some of the displacement of the implant and your pain. Both of these conditions are not totally unusual following a pregnancy. An evaluation by a plastic surgeon will give you options for restoring the size and shape of your breasts. This most likely will include a breast lift, addition of fluid to the implants or re-arrangement of the implant in the capsule pocket. I hope that this helps.

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