anatomical implant flipping - Can this be resolved?

Question

My implant flipped once and I had a revision. Now I suspect it flipped again! Can this be resolved? Do I need round implants? I am tall and choose the smallest implants they could recommend for my larger frame, a300 cc, I'm 177 cm and slim.

Derek Fletcher, MD · Answer

I am sorry you are experiencing implant flipping. The answer to your question depends on what was done during your revision. The three most common options are as follows: 1. Tighten the capsule around the implant (capsulorraphy). This option causes the least amount of new injury to your body. But the strength of the repair is only as strong as the soft tissues around the implant. If a person has delicate tissues, this is not a reliable solution over the longterm. 2. Implant position change from sub glandular to sub muscular or visa versa. This is probably the most common strategy and is typically very reliable because it positions the implant in a space that has not experienced the stress of supporting an implant before and it gives the surgeon the opportunity to perfectly dimension the pocket for the implant. It comes at the cost of a new injury to your body, but is usually worth the added recovery time.3. Wrap the implants in acellular dermal matrix (AlloDerm or Stratice), which can provide additional security because the surgeon has complete control over implant position. The wrap itself is very secure and it very difficult for an anatomic implant to flip or rotate. However, this option is very expensive and typically reserved for insurance-based breast reconstruction.
Changing to smooth, round implants may be the best option for you depending on what was done during your operation, the strength/integrity of your soft tissues, and your goals.

Daniel Barrett, MD · Answer

Dear louislane,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

That has often been the problem with anatomic implants and why fewer surgeons use them. Get them replaced with round implants

Sarper Mete, MD · Answer

Trauma To The Breast:Enduring any type of trauma to your breast implants be it in a sporting activity or accident, will increase your chances of flipping them.Insufficient Post-Operative Rest:As a matter of fact, every surgical procedure requires rest. Notably, overuse of your upper chest muscles immediately after the breast augmentation procedure can also become the cause of malrotation.It is advisable to avoid any vigorous breast massages until your surgeon gives you the green light.Capsular Contracture:After the surgery when your body starts healing, they will form capsular scar tissue around the breast implant site. But when the scarring starts becoming intense and causes chronic pain, you develop capsular contracture.It forms a thick and firm layer that starts squeezing your breast implants eventually causing them to flip. This is a serious condition that will need medical attention immediately.Large Implant Pocket:In order to insert the implants, the surgeon creates a breast pocket. However, if your breast pockets get too large, your implants will have more room to rotate or move. Large pockets could also be due to gravity taking its toll, lactation, aging, or even tissue factors such as stretching or thinning of the breast skin.Breast malrotation can cause all sorts of complications related to asymmetry and deformity and requires an operation to correct or stop them from getting worse.
Is It Dangerous?This condition is not life-threatening but no one would like to live with it after getting a breast augmentation. It will surely feel uncomfortable but you would also have to live with the unsymmetrical appearance.Though you might experience discomfort you will definitely not feel pain except in trauma or capsular contracture. That is one of the reasons they often go undetected.How To Avoid Flipping Or Malrotation Of Breast Implants?Precaution is always better than looking for a solution. Your chances of getting your implants flipped will decrease when you will follow your surgeon’s instructions and recommendations.Last but not the least, choosing the right surgeon can minimize the risk of malrotation.  Sarper Mete MD is not only a well-qualified cosmetic surgeon but a seasoned one too who has successfully performed hundreds of breast implants in the past.

Connie Hiers, MD, FACS · Answer

Since yours has flipped twice, I would suggest changing to a smooth round implant. When standing, even round implants have an anatomical shape.  I prefer the smooth round implants for fewer long term risks.

anatomical implant flipping - Can this be resolved?

Answers (5)

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