Breast implants flipping - how can this be fixed? (Photo)

Question

Had a prophylactic mastectomy in 2023 with expanders placed. In 2024 I had the expander taken out and implants placed my implants constantly. Is that normal?

Emre Guvercin, MD, FEBOPRAS · Answer

In your situation, implant movement is not the only issue. Based on what you describe, there is also significant skin excess and true sagging, which changes how the implant behaves inside the breast.After a prophylactic mastectomy:The skin envelope is often overstretched from expandersNatural internal support structures are lostExcess skin allows the implant to shift, drop, and feel unstableIn these cases, pocket tightening alone is usually not enough.Why a lift (mastopexy) is important hereA breast lift in post-mastectomy reconstruction:Removes excess, lax skinRe-centers the breast envelope over the implantImproves implant stabilityReduces downward and side-to-side movementRestores a more natural breast shape and positionWhen significant sagging is present, a lift helps the implant sit higher and more securely, rather than “floating” in a loose pocket.What a combined revision may involveIn many patients like you, the most effective correction includes:Mastopexy (lift) to address skin excess and saggingPocket revision (capsulorrhaphy) to stabilize the implantPossible internal support (mesh/ADM) if tissue quality is weakThis is a common and valid secondary reconstructive approach and is not unusual after expander-based reconstruction.

Jacob Carlson, MD · Answer

An implant that flips in position is not terribly uncommon. It usually indicates that the space around the implant (the "capsule" or the "pocket") is a little looser than is ideal. Other factors to consider are the profile of the implant and the position of the implant. An implant that is higher profile is slightly more likely to flip, simply because of the shape of the implant. With respect to implant position, implants that are "on top of the muscle" are more prone to flipping than implants that are "under the muscle."
Depending on which of those factors are contributing to the implant flipping, options to address them include capsulorrhaphy, changing the implant to a lower profile, and changing the position of the implant.
In a capsulorrhaphy, the surgeon manipulates the space around the implant to make the tissue around the implant tighter, so then the implant is less likely to flip.
Changing the implant to one that has a wider diameter (lower profile) means that the base of the implant is wider, so it has a lower likelihood of flipping over.
Moving an implant that is on top of the muscle to underneath the muscle can create a space where the implant has less space to flip. The constraint of space created by the pectoralis muscle can hold the implant in the proper orientation.

Breast implants flipping - how can this be fixed? (Photo)

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