When I started out as a plastic surgeon some 30+ years ago, there were maybe a handful of breast implant options—if you wanted breast augmentation, you picked a size, and that was that. Today, there are literally hundreds of choices.
I exclusively use smooth, round silicone gel implants for my patients. There are numerous advantages of this implant type over the others, but today I’d like to focus on one breast implant phenomenon that’s more common than you might realize—and that you probably won’t notice in my patients because of the type of implants I use—breast implant flipping.
Breast implant flipping is really just what it sounds like: the implant flips over in the breast pocket. It can flip along any axis: from front to back (like flipping a pancake), rotate around like a wheel, or even pivot so that the “side” of the implant is facing forward (like a door opening).
While not exactly common, breast implant flipping isn’t rare. Studies estimate that somewhere between 3% and 14% of patients have a malpositioned (rotated) implant. We cannot tell for sure, because not every patient with a rotated implant notices the issue, particularly if the implants are round to begin with.
There are several factors that can make it easier for an implant to flip over, one of them being pure chance. Vigorous breast massage and/or exercise can also cause an implant to turn the wrong direction, particularly if these activities are done before the breasts have fully healed after surgery.
Sometimes, the breast pocket, or the space the plastic surgeon makes between the breast tissue and/or muscle for the implant, is too large. In such cases, the natural capsule of tissue that forms around the implant leaves room for the implant to flip around.
Implants with smooth shells are more likely to rotate, so manufacturers now make anatomically shaped implants with textured surfaces. The idea is that the breast tissue will grab onto the rougher surface, helping hold the implant in place. It helps considerably, but it’s not foolproof. If the pocket is too large, the implant will likely rotate. Again, not such a big deal with a round gel implant.
With anatomically shaped (teardrop) breast implants, a flipped implant can usually be noticed when looking at the breast. Because these implants hold their shape no matter what, if they rotate, the breast will have a distorted shape. For example, if it flips over like a pancake, the front of the breast will look flat. If you have round gel implants, you won’t likely notice anything at all, as they will keep the same shape in any direction.
A surefire way to detect a rotated shaped implant is to get an ultrasound or MRI. Routine imaging is already recommended for patients with silicone implants, and can confirm what position the implant is in.
A rotated or flipped implant is not considered a serious complication. If you have a rotated round implant, you likely will not notice it. However, it can be uncomfortable for a shaped implant to rotate, as it will push on your breast tissue in an abnormal way. Of course, the aesthetic effect also won’t be desirable.
While not an emergency, if you suspect that one or more of your breast implants has rotated, or your breast has changed shape unexpectedly, you should contact your plastic surgeon first to rule anything else out, and then to figure out the best solution.
Yes. A flipped or rotated implant can be corrected and returned to its proper position in one of two ways:
Your plastic surgeon is the best person to help you decide on the best method of flipped implant correction.
While it is possible to correct a flipped implant, you would probably rather just not worry about your breast implants flipping or rotating at all. So would I. This is one reason I exclusively use smooth, round silicone gel implants for my Honolulu breast augmentation patients, favoring SoftTouch implants in particular.
I strongly prefer the SoftTouch implants because they have a smooth shell (which is considered safer), a softer cohesive gel that moves and feels just like a real breast, and the shell is filled optimally to provide a natural look with minimal chance of rippling or wrinkling. I can place the SoftTouch implants through a transaxillary incision (not possible with shaped implants), avoiding a breast scar altogether. Plus, my patients love them.
Moreover, the more flexible gel in the smooth, round implants is designed to move naturally with gravity. When a patient stands up, the implant will still be slightly fuller at the bottom, and gently tapered toward the top—just like natural breasts, and similar to a shaped implant. When the patient lies down, the implant flattens out like a natural breast. In fact, when placed by an experienced plastic surgeon, round implants can actually achieve a more natural breast shape for patients than “natural” teardrop shaped implants!
I haven’t met a single breast augmentation patient who has envisioned anything less than having beautiful, naturally shaped breasts after surgery, and I’m happy to say that it’s very rare that one of my patients is anything less than thrilled with her results. If you have any questions or want to talk to me about your Honolulu breast augmentation options, please call my office at 808-597-8835 or contact me here.