Replace Breast Implants Due to Corner Fold?

Question

I have a fold in my left breast in the corner that I can feel. My doctor reassures me that this is alright and once the capsule regrows over the implant I will feel it less and not notice it. Folds are part of breast implants. Is this true? Should I replace the implant even though it is just a fold?

Ricardo L. Rodriguez, MD · Answer

Read that you had textured implant. Your surgeon might be right to have you wait if your implant was done less than a month ago. 
I personally like to wait 4 months before deciding what is to be done.
Rather than replace the implant, you might think of a couple of things:
1. If you can't see it, is it really worth your while to go thru surgery again?
2. Since it is silicon, there is no problem anticipated with implant wear and tear at the fold crease. If it was saline, one would worry about the fold crease being a locus for deflation in the future.
3. If it really bothers you after a suitable amount of time has passed, consider something less involved, such as a fat transfer to the area to soften the feel of the implant fold.

Sam Speron, MD, FACS · Answer

Hi Lisa,
Unfortunately, folds are common in implants, especially saline implants. Most of the time, your implants will look OK, but it may be uncomfortable to feel the fold. 
If it is too uncomfortable for you or becomes problematic, you should see your plastic surgeon, as a possible replacement may be necessary. 
It is important to keep in mind that there is still always a possibility of folds with the replaced implants. In general, the more soft tissue covering a patient has over the implant, the less likely she is to feel the implant and its folds. 
Obviously, most patients getting breast augmentation have thinner tissues. Generally silicone implants are less likely to fold than saline implants, but this is not always the case.
Thank you for you question! Have a great day!
Best regards,
Dr. Speron

Mitchel Krieger, MD · Answer

Palpable corners or folds of an implant are commonly seen in women. When implants replaced, very little natural soft tissue is available cover the implant. This is generally most noticeable with saline implants. This does not represent an error the way the surgery was performed, but merely a shortcoming of the type of implant chosen for certain anatomic situations.  
The edge of the implant is generally palpable in the lower outer aspect of the breast. In this situation, switching from sailing to silicone gel implants might improve the situation. Smooth walled silicone gel implants very soft and natural feeling and will generally be less apparent in women with poor soft tissue coverage.  
If the palpable edge of the implant does not concern you, then there is no reason to do a thing. Being able to feel the edge of the implant should not increase your risk for leakage or complications associated with the implant. If you have continued concerns about this, I would encourage you to discuss it further with your plastic surgeon.

Bahram Ghaderi, MD · Answer

Feeling the implant folds is normal. Some factors may accentuate those areas, however. If the implant is too big, if the implant pocket is above the muscle, if you have textured implants, if you have saline implants and they were underfilled, if you have lost significant weight recently or anything else that may have resulted in less tissue coverage such as changes you see after pregnancy or if you implant has deflated. You can go over these issues with your surgeon. Otherwise, it is normal to have some palpability of any implant - specially on the sides and underneath the breast.

Robin T.W. Yuan, MD · Answer

All implants have folds but whether the folds are problematic depends on various factors. If the fold is pressing against the skin enough, it might cause soft tissue erosion and thinning. Excessive folds can increase the risk of leakage due to "fold failure". If it is not seen and only felt, it might be less significant and there would be no need to change things.

Michael C. Edwards, MD, FACS · Answer

Implants are soft and I tell everyone of my patients they will be able to feel them through their breast tissue, especially in the lower outside part of the breasts. I very rarely place implants above the muscle to minimize the chance of implant visibility or palpability in the upper inner breast area. Every woman is different in their anatomy and it does take weeks to months to get your final results. It's also important to point out that saline implants will be more "feelable" than silicone implants but both will have some folding. 
Dr Edwards

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