What can be done if my breast implant keeps flipping from front to back? (Photos)

Question

I had 605cc implants put in a year ago. I only asked for 450cc. My right side has never felt right. Flatness where the nipple is, weird rolling sensation when I lay on my back, and still cant touch it without soreness. The implant has flipped front to back multiple times including having the nurse flip it back in office. My surgeon is now telling me there is nothing he can do and I shouldnt be experiencing pain, which I am when it flips. Is this normal or fixable?

Richard Baxter, MD · Answer

This is not common but I believe it is more likely with higher profile implants especially under the muscle. Options include tightening the pocket to prevent the lateral displacement and help prevent the implant flipping, switching to smaller implants, and if the muscle is significantly moving the implants then you may need to change the plane and put them in front.

Daniel Barrett, MD · Answer

Dear Aprilshowers2685,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

All smooth implants can potentially flip. However, your pocket can be tightened to make less room for the implant to flip. If your implants are behind the muscle and they flip with flexing, your implants could be moved to sit in front of the muscle. You might even consider going smaller if you have pain when the implants shift.

Tom J. Pousti, MD · Answer

I am sorry to hear about the problem you are experiencing. You demonstrate your concerns nicely. Although some “falling to these sides” of breast implants is quite normal when you lie down, if this occurs “excessively”, it may be a concern to patients.  This phenomenon is called lateral displacement of the breast implant;  it may be of concern from the visual and the discomfort standpoints (soreness or pain is certainly consistent with a breast implant displacement problem). Surgical correction is an option.
Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline.    In my practice, I use a 2 layered suture technique (capsulorraphy) to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option (although not usually necessary) especially if significant implant rippling/palpability is present.
 There are several important "factors" involved in this type of revisionary breast surgery. Most important (in my opinion): plastic surgeon experience level.     In other words, experience level and technical expertise play the biggest role when it comes to successful  outcomes with this type of revisionary breast surgery.   Careful attention to postoperative activity limitations as well as use of appropriate postoperative support of dressing/garments are also important.
 
 I hope this helps.

Jason Pozner, MD · Answer

I have seen this a few times. If the implant is flipping the pocket is too big. Closing down the pocket should fix this. It may improve the flatness as well. The soreness probably has nothing to do with the enlarged pocket and should improve over time on its own

What can be done if my breast implant keeps flipping from front to back? (Photos)

Answers (5)

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