Is it possible for implants to move from under the muscle to over?

Question

I am currently 49 years old and got saline implants 15 years ago my doctor said he placed them under the muscle. When I went to have my mammogram this year the tech told me my implants are now over the muscle. Is it possible for implants to move from under the muscle to over?

Stanley Castor, MD · Answer

Hello, it is possible for implants to move from under the muscle to over, but extremely unlikely. I have seen it happen, but only on one side. More than likely, the doctor may be mistaken about the placement. Or the mammogram tech is mistaken about the position. I would wait for the final mammogram reading from the Radiologist to determine what position your implants are in. Best of luck!

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question! When implants are placed "under the muscle" the most common technique is actually a "dual plane" technique whereby a portion of the pec major muscle is "lifted up" in order to accomodate a space for the implant between the muscle and the chest wall. The implant ends up with its top portion covered by the muscle (actual percentage variable dependent on patient and technique variation) and in the bottom portion it is actually not covered by muscle but only by the breast tissues. Over time, changes in age, hormones, tissue quality and gravity in general will result in the breast tissues sagging. It is possible for the implant to descend downwards as well. It is speculation, but your implant may only be minimally covered or now not at all covered in its top portion by the muscle depending on the degree of these changes and this is why imaging may show "no muscle" in front of the implant. The question of "moving/flipping" from under to above the muscle is not very likely as the the breast tissue connections to the muscle below it would need to be surgically separated to create a true pocket/space for an implant.

Daniel Barrett, MD · Answer

Dear rrollins06,
it is hard to tell without an examination, but generally speaking it is possible for implants to move. If you are concerned, you should visit plastic surgeon and get an examination. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Tyler Frew, MD · Answer

Hi there,
I have never heard of or seen implants flip from over the muscle to under without surgical intervention. You surgeon likely placed them over the muscle.
The mammogram tech could have possibly made a mistake as well.
You can try and flex your pec muscles to see if the implants move, if they move they are likely under the muscle. A quick consult or visit to any plastic surgeon and they will be able to tell you
All the best

Ted Eisenberg, DO, FACOS, FAACS · Answer

A normal fibrous capsule forms as early as 3 weeks after surgery around the implant, a fact which would prevent the implant to move from one space (behind the muscle) to a completely new space (above the muscle). Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Karl William Schwarz, MD · Answer

I would always take what a tech says with a grain of salt and technically they are not really supposed to discuss the results of a mammogram as it needs to be read by the radiologist. I think most likely what she is seeing is the lower part of the implant is under the gland which everyone who has a submuscular implant is actually not under the muscle in the lower part of the breast but under the gland. I have attached a video explaining why.

I cannot imagine nor have I ever seen an implant move to a subglandular pocket from a submuscular pocket as the breast tissue above the muscle would have to be separated from the muscle and it's not possible for an implant to do that.

I cannot imagine nor have I ever seen an implant move to a subglandular pocket from a submuscular pocket as the breast tissue above the muscle would have to be separated from the muscle and it's not possible for an implant to do that.

Connie Hiers, MD, FACS · Answer

Yes, implants can slip out from behind the muscle over time, especially with large implants that were barely behind the muscle from the start.

Is it possible for implants to move from under the muscle to over?

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