7 months post op and my breast shape has changed - can this be due to implant flipping?

Question

Breast implants 7th September 22, initially happy and no problems. Signed off to commence CrossFit exercise in December. Shape changed in February, surgeon says just loss of tissue and hormones but mri shows significant difference. Even with this evidence and a 2nd opinion saying flipped he maintains that it’s just my body changes. Can I have opinions here please. He said my options are to gain weight or have fat injections or places under muscle instead

Andrea Marando, MD · Answer

Thank you for your questions and for uploading photographs and scan.

Sorry to hear that you are experiencing some problems after your procedure.

It is not unusual for implants to rotate in time, depending on size, degree of laxity / skin excess and physical activity. If it has been confirmed the implant has rotated, fat grafting would not necessarily be the best option and even if the implant is de-rotated in theatre, it is likely that it will happen again, unless either the existing pocket is reduced in size, both implants are placed sub-muscular or the skin excess / laxity is reduced with a lift.
These are some of the options to discuss  with your surgeon, who has examined you and followed you in your journey so far.

All the best.

Andrea Marando
Consultant Plastic and Cosmetic Surgeon at Star Clinic
Manchester and London, UK

Hampton A. Howell, MD · Answer

Hi.  Based on your pictures and the image of the MRI, it does look like your left breast implant has flipped or partially flipped.  There is certainly no danger in this but it does tend to change the shape of the breast.  Often times this can be manipulated in the office or at home to get the implant to flip back around.  But the reality is that there is really no way to keep the implant from flipping or to keep it in one particular position or another from a flipping standpoint.  The way your implant is sitting it is possible that the pocket may have tightened up just a little bit on that left-hand side which is also not any particular problem per se, but opening the pocket a little bit more may allow the implant to sit more horizontally, so to speak, rather than at an angle.  Either which way you can certainly consider getting another opinion from a board certified plastic surgeon with good experience with breast augmentation to help you through the process as well as your options.  Those obviously will need to be made based on an in-person evaluation.
Good luck and take care,
Dr. Howell

Martin Jugenburg, MD · Answer

Hello thank you for your question. Natural breast tissue along with all human tissue can change on its own over time. Those seem like appropriate options to give it a try. Speak to your plastic surgeon about your options and what you feel more comfortable with.

Daniel Barrett, MD · Answer

Dear nicola111,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ryan Rebowe, MD · Answer

It is difficult to tell with the provided pictures and imaging. In general, only an in person physical examination would be able to tell whether or not the implant has flipped. With many implants they will look the same on both sides with the exception of some of the form stable 5th generation devices which are textured and should not flip or rotate. I appears that you do not have much breast tissue on the left based on the MRI which is consistent with body changes including weight loss, weight gain, or hormone changes. I would agree with your surgeon that moving them below the muscle can help as can fat grafting. Again, only an in person physical exam will be able to tell the next best step as well as consulting with a board certified plastic surgeon.

Zoran Potparic, MD · Answer

Based on the MRI images and clinical appearance, it appers that you may have capsular contracture around implants or implant have rotated. Only on the basis of in person evaluation this can be confirmed and meathod of correction discussed. Hope this helps. Good luck.

Randal Haworth, MD, FACS · Answer

I'm sorry to hear that you are experiencing concerns with your breast implants. Without examining you, it's difficult to provide a definitive answer, but I can provide some general information that may be helpful.

Changes in breast shape or appearance after breast augmentation can occur for a variety of reasons, including changes in weight, hormonal fluctuations, or implant displacement. In some cases, implant malposition or rotation may be the underlying cause of these changes.

An MRI can provide valuable information about the position of your breast implants and can help identify any issues with implant placement or rotation. If your MRI shows a significant difference in the position of your implants compared to when they were initially placed, this may be an indication that they have shifted or rotated. An implant that has rotated out of its proper position can cause changes in breast shape and appearance.

A second opinion from another board-certified plastic surgeon can also be helpful in determining the cause of your concerns. If the second opinion suggests that your implants have flipped or are malpositioned, it may be worth discussing your options with your original surgeon or seeking out a new surgeon for a consultation.

Your options may include having your implants repositioned or replaced, either with the same type of implant or a different type of implant that is better suited to your needs. Fat grafting or the use of tissue fillers may also be options to consider, although it's important to discuss the potential risks and benefits of these procedures with a qualified medical professional.

Ultimately, the decision of how to proceed should be based on a careful consideration of your individual needs and goals, as well as your surgeon's professional advice and recommendations. If you are not comfortable with your surgeon's recommendations, seeking out a second opinion or a new provider may be appropriate.

Best of luck !

Connie Hiers, MD, FACS · Answer

All implants, especially smooth ones, can flip. With a bigger pocket, there can be more flipping.  Cross fit training will encourage lots of breast movement and risks flipping. Your tissue medially is thinned and is letting your implant push through. Tissue is needed to cover that area. Your surgeon is correct in choices. In the meantime, wear a very good tight supporting bra while exercising. Don't let the girls bounce.

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

I can not give you individual advice without a consultation and examining you. However, implants can flip and the result is often a flattened appearance to the breast and an asymetric appearance in the cleavage area like in the photograph. I have rotated implants back from flipped to the correct orientation on several occaisions in the clinic without an operation. They may re flip but unflipping is possible.I advise you to consult a suitably qualified and expereince plastic surgeon to advise you. You could ask them about 'flipping' your implant back if they consider it has flipped.Good luck and best wishes.

Camille Cash, MD · Answer

Based on the MRI submitted it appears your implant is malpositioned or potentially an issue with the capsule or pocket.  It may benefit you to seek a second opinion if you are not satisfied with the explanation from your surgeon.

7 months post op and my breast shape has changed - can this be due to implant flipping?

Answers (11)

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