In this guide11 sections
- How to Find Out If Your Breast Implant Has Flipped or Rotated inside your Breast (Malrotation)
- What is a Flipped Breast Implant?
- What causes a flipped breast implant?
- How can I tell if my implant has flipped?
- Are rotated breast implants painful?
- How Are Flipped Implants Diagnosed?
- Is a flipped breast implant dangerous?
- Treatments for a Flipped Breast Implant
- How to Prevent a Flipped Breast Implant
- Frequently Asked Questions About Flipped Breast Implants and Malrotation
- SPECIALIST PLASTIC SURGERY CLINIC IN LONDON
How to Find Out If Your Breast Implant Has Flipped or Rotated inside your Breast (Malrotation)
Breast augmentation is a widely popular cosmetic procedure that many women undergo to improve their breast size and shape. In the UK, it is considered the top cosmetic plastic surgery option. Breast implants, which are inserted during the procedure, can significantly boost one’s self-confidence and give them the desired physical appearance.
Centre for Surgery is a plastic surgery clinic that provides high-quality breast augmentation services. The procedure involves the insertion of implants, which can enhance the size and shape of the breasts, making them look more symmetrical, perky, and aesthetically pleasing.
However, like any other surgical procedure, breast augmentation comes with some post-operative complications. One such complication is a flipped breast implant, also called breast implant flipping, implant rotation, or malrotation, where the implant rotates inside the breast. This can cause discomfort and asymmetry and affect the aesthetic appearance of the breasts. It’s worth being clear that a flipped or rotated implant is a distinct complication from implant displacement, where the whole implant shifts position within the pocket rather than rotating on its own axis — the two are sometimes confused, but the causes and signs differ.
It is crucial for patients who have undergone breast augmentation to monitor their breasts and observe any changes that may occur. Regularly checking for any unusual lumps, changes in breast shape, or any other unusual symptoms is recommended. If you notice any signs of a flipped or rotated implant, it’s important to consult with your surgeon immediately to prevent any further complications.
What is a Flipped Breast Implant?
A flipped breast implant, also known as implant flipping, rotation, or malrotation, is a recognised complication that can occur after breast augmentation surgery. It is one of the primary reasons why patients undergo revision breast surgery or mammoplasty.
In essence, a flipped breast implant is when one or both implants rotate from their original position, causing the back surface of the implant to face forward instead. This movement can cause asymmetry, discomfort, and affect the overall appearance of the breasts.
Patients who experience a flipped or rotated implant may notice a change in breast shape, feel discomfort, or notice an unusual lump. It’s essential to seek immediate medical attention if you experience any of these symptoms. Your surgeon can assess the situation and determine the best course of action to fix the problem.
In some cases, implant flipping can occur due to implant malposition or improper surgical techniques. Choosing an experienced and qualified surgeon at Centre for Surgery and following post-operative care instructions can help reduce the risk of complications such as a flipped or rotated implant.
What causes a flipped breast implant?
Breast implant malrotation, also known as implant flipping, can occur due to several factors. Below are some common causes of a flipped breast implant:
BREAST IMPLANT TYPE
The type of breast implant can also contribute to implant rotation. Some implant models have a smooth shell and a round profile, which makes flipping more likely to occur. However, newer breast implants, such as Silimed, have adhesive surface technology that allows for proper prosthetic fixation to the surrounding tissue. Moreover, they cause less inflammation to the surrounding tissue, which can be a reason for capsular contracture, another cause of implant flipping.
LARGE IMPLANT POCKET
During the surgery, the plastic surgeon creates a breast pocket beneath the breast mound or chest muscles to place the implants. If the breast pocket is too large, the implants will have more room to flip or rotate, back to front or upside-down. This can be due to other factors such as gravity, lactation, ageing, and tissue factors like stretching and thinning.
BREAST TRAUMA
Any trauma to the breast can cause the implant to move out of its position. This can happen due to accidents, sports injuries, or any other physical impact.
INSUFFICIENT POST-OPERATIVE REST
Following the breast augmentation procedure, it’s crucial to rest and allow the implants to settle into place. Lack of proper post-operative immobility can prevent proper implant fixation, allowing the implants to rotate. Patients should avoid vigorous breast massages and overuse of the upper chest muscles until their surgeon gives them clearance to do so.
CAPSULAR CONTRACTURE
After breast augmentation surgery, the body naturally forms a layer of capsular scar tissue around the implant site. Capsular contracture is when the scarring becomes intense, forming a thick and firm layer that squeezes the breast implant. This can cause chronic pain, and in some cases, the implant may flip back to front or upside-down.
Capsular contracture is graded on the Baker scale from I to IV: Grade I is normal, soft tissue with no visible or palpable change; Grade II is mild firmness without visible distortion; Grade III involves firmness with visible distortion of the breast shape, which is where a rotated or flipped implant becomes more likely; and Grade IV is severe firmness with pain and significant distortion. Grades III and IV typically warrant surgical correction, and addressing the contracture is usually necessary alongside correcting the flip itself, since treating the rotation alone without addressing the underlying capsule tends to result in the same problem recurring.
How can I tell if my implant has flipped?
It can be challenging to tell if you have a flipped or rotated breast implant, but it’s crucial to be able to identify the signs. Round implants may keep their shape regardless of the direction they are in, making it difficult to notice if they’ve flipped. However, regular imaging studies recommended after augmentation mammoplasty can confirm the position of the implants.
On the other hand, a flipped tear-drop-shaped implant, which mimics the natural anatomical shape of the breasts, is more noticeable. Such implants hold up their shape regardless of their position, so if they rotate, it can cause significant changes in breast appearance and feel. The following are some common signs of a flipped tear-drop-shaped implant:
VISUAL DIFFERENCE
The breast with a flipped implant may visually differ from the other breast when compared from left to right. There may be an asymmetrical appearance.
DIFFERENT TEXTURE
The breast with a flipped implant may feel different from the other breast when touched. It may feel firmer, softer, or lumpy.
ASYMMETRY
The breasts will no longer be symmetrical as they were immediately after the procedure.
DISCOMFORT
A flipped or rotated implant can cause discomfort when lying down or standing up. The breast may feel heavy or painful.
Are rotated breast implants painful?
Breast implant malrotation, also known as flipping or rotation, may or may not cause pain or discomfort. In some cases, a rotated implant may be asymptomatic, meaning the patient may not experience any pain or discomfort.
However, if malrotation is accompanied by capsular contracture, which is the hardening of the tissue capsule around the implant, it may cause pain, discomfort, and distortion of the breast. Capsular contracture can cause the implant to be squeezed, leading to pain and discomfort. In such cases, revision surgery may be required to fix the malrotation and address the capsular contracture.
Trauma or injury to the breast can also cause malrotation, which may result in pain or discomfort. It’s important to contact your surgeon if you experience any unusual pain, discomfort, or changes in breast appearance after breast augmentation surgery.
How Are Flipped Implants Diagnosed?
A flipped or rotated breast implant can be diagnosed through a combination of patient description and a physical examination by a qualified plastic surgeon. Typically, patients may notice asymmetry or misshapen breasts and report these changes to their surgeon. During a physical examination, the surgeon will assess the breasts for any signs of malrotation, such as a rotated implant or a distorted breast shape.
However, in the case of round-shaped breast implant malrotation, it can be difficult to recognise through physical examination alone, particularly in patients with ample soft tissue coverage. In such cases, imaging studies such as ultrasounds and magnetic resonance imaging (MRI) can be useful in confirming the diagnosis.
Ultrasounds can provide high-resolution images of the breasts, which can help identify any changes in implant position and detect any fluid collections around the implant. MRI, on the other hand, can provide detailed images of the breast tissue and the implant, making it a valuable tool in detecting malrotation and capsular contracture.
Is a flipped breast implant dangerous?
While a flipped breast implant may not be a life-threatening complication, it can have significant cosmetic consequences and impact the patient’s quality of life.
A flipped breast implant will have its back (and often flat) part facing forward, which can give the breast a flattened appearance. This can cause asymmetry, discomfort, and affect the overall aesthetic appearance of the breasts. Patients may notice a loss of roundness in the upper poles of the breasts, and in some cases, the edges and contour of the implant may be visible.
If the breast implant flips and bottoms out, dropping low in the breast pocket, the nipple may sit too high on the breast mound and poke out of the bra, causing additional discomfort and aesthetic concerns.
A flipped or rotated implant can also cause psychological distress and self-esteem issues for patients who have undergone breast augmentation surgery to improve their physical appearance. Revision surgery may be required to fix the flipped implant and restore the desired appearance of the breasts, which can be time-consuming and costly.
Treatments for a Flipped Breast Implant
If you have a flipped or rotated breast implant, there are approaches your surgical team can take to fix the issue.
DO NOT ATTEMPT TO SELF-CORRECT
It’s important to know that self-manipulation is not something we recommend or teach patients at Centre for Surgery. If you suspect your implant has flipped or rotated, do not attempt to press, massage, or otherwise reposition it yourself. Attempting to manually re-flip an implant without proper clinical assessment can risk further complications, mask an underlying cause such as capsular contracture that genuinely needs addressing, or cause additional trauma to the healing tissue. Contact your surgical team promptly instead, so they can properly assess the cause and recommend the safest, most effective correction.
REVISIONAL SURGERY
If a flipped or rotated implant is confirmed, breast implant revision surgery is typically the appropriate correction. This can involve tightening the breast implant pocket and repairing it if the cause is due to breast pocket over-dissection. In other cases, the implants may be too large for the patient’s physique, requiring the implants to be replaced with more fitting ones.
In some cases, breast malrotation may be due to unique chest anatomy, such as a chest deformity, requiring a tailored correctional breast surgery to meet the patient’s needs.
Where repositioning is not the right route, breast implant removal is another option to discuss with your surgeon.
How to Prevent a Flipped Breast Implant
Breast implant malrotation is a recognised complication of breast augmentation surgery. However, there are steps you can take to reduce the risk of a flipped or rotated implant and ensure the best possible outcome after surgery. Here are some preventative measures to consider:
CHOOSE A QUALIFIED SURGEON
Always choose a qualified and experienced plastic surgeon for your breast augmentation surgery. A surgeon who specialises in breast augmentation and revision surgery is best suited to prevent and treat a flipped or rotated implant.
USE HIGH-QUALITY IMPLANTS
Opt for high-quality breast implants from reputable manufacturers. At Centre for Surgery, we use Silimed Implants, which are made of medical-grade silicone and designed to mimic the look and feel of a natural breast. These implants have a smooth surface but are covered with an adhesive outer layer that promotes fixation to nearby tissue, reducing the risk of flipping.
FOLLOW POSTOPERATIVE CARE INSTRUCTIONS
Proper postoperative care is crucial in reducing the risk of implant flipping. Follow your surgeon’s instructions carefully and avoid any strenuous activities that could cause trauma to the breasts. Avoid aggressive massaging or excessive use of the upper chest muscles until your surgeon gives you the green light to do so.
REGULAR CHECK-UPS
Attend regular check-ups with your surgeon to monitor the condition of your implants and detect any issues early on.
Frequently Asked Questions About Flipped Breast Implants and Malrotation
CAN I FIX A FLIPPED BREAST IMPLANT MYSELF?
No — we don’t recommend attempting to self-correct a flipped or rotated implant. Pressing or manipulating it yourself can risk further complications or mask an underlying cause that genuinely needs assessing, such as capsular contracture. Contact your surgical team as soon as you notice any signs, and they’ll advise the safest way forward.
HOW OFTEN SHOULD BREAST IMPLANTS BE CHECKED?
Breast implants should be checked regularly by a qualified plastic surgeon, particularly in the first few months after surgery. After the first year, it’s recommended to have annual check-ups with your surgeon to monitor the condition of your implants and detect any issues early on. Any changes in breast appearance or discomfort should be reported to your surgeon immediately.
WHAT HOLDS BREAST IMPLANTS IN PLACE?
Breast implants are held in place by the tissue capsule that forms around the implant after surgery. The tissue capsule is a natural response of the body to a foreign object, and it helps keep the implant in place. The implant may also be placed under the chest muscle to provide additional support.
HOW OFTEN DO IMPLANTS ROTATE?
Implant rotation can occur at any time after surgery, but it’s most common in the first few months after surgery. The risk of rotation decreases over time, but it’s still possible for implants to rotate years after surgery. The incidence of implant rotation varies depending on the patient, the type of implant, and other factors.
WHAT IS BOTTOMING OUT OF THE IMPLANT?
Bottoming out is a complication that can occur when the implant settles too low in the breast pocket, causing the nipple to sit too high on the breast mound. This can happen when the breast pocket is over-dissected or the implant is too large for the patient’s physique. Bottoming out can be corrected with revision surgery.
HOW MUCH DOES IT COST TO FIX A FLIPPED BREAST IMPLANT?
This depends on what correcting it involves — whether it’s straightforward repositioning, pocket revision, or addressing capsular contracture at the same time. Costs vary accordingly, and your surgeon will confirm an exact quote in writing following a consultation and physical assessment. See our breast implant replacement cost guide for indicative pricing.
IS A FLIPPED IMPLANT THE SAME AS A DISPLACED IMPLANT?
No — they’re related but distinct complications. A flipped implant has rotated on its own axis so the back of the implant faces forward, while a displaced implant has shifted position within the pocket without necessarily rotating. See our guide on breast implant displacement for the signs and causes specific to that complication.
SPECIALIST PLASTIC SURGERY CLINIC IN LONDON
At Centre for Surgery, our plastic surgeons have years of experience and training in breast augmentation surgery. We are dedicated to providing the best possible patient care and education, ensuring that each patient receives a customised treatment plan that meets their unique needs and desired surgical outcomes.
We understand that breast augmentation surgery is a significant decision and strive to make the process as comfortable and stress-free as possible for our patients. Our surgeons utilise the latest surgical techniques and technology to ensure good results and minimise the risk of complications such as a flipped or rotated breast implant.
We also place a strong emphasis on patient education, ensuring that our patients fully understand the procedure, the risks and benefits, and what to expect during the recovery process. Our goal is to provide each patient with the information and support they need to make an informed decision about their breast augmentation surgery and achieve their desired outcomes.
