Breast Implant Flipped or Rotated?

How to Know If Your Breast Implant Has Flipped (Malrotation) Blog on Coco Ruby Plastic Surgery - Woman with Nice Boobs and Long Hair

How to Know If Your Breast Implant Has Flipped or Rotated inside your Breast (Malrotation)

Breast Augmentation continues to be the number one most sought-after cosmetic plastic surgery, and not without good reason. Breast Augmentation can increase your breast size and enhance its shape through the insertion of implants. It’s a powerful life-changing procedure that can help give you the symmetrical, perky, and overall more aesthetically pleasing boobs of your dreams.

A breast augmentation procedure can have certain post-operative complications. Breast implant flipping, also known as breast implant malrotation is one of them.

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What Is Breast Implant Flipping?

Implant flipping or malrotation is a typical complication of breast augmentation surgery and one of the more common motivations behind revisional breast surgery (mammoplasty). It is when one or both of your breast implants fail to remain fixed in their original position after your boob job surgery, rotating in such a way that the back surface of your implant faces forward instead. Visualize flipping a hamburger but without the delicious and welcomed outcome.

What Causes Breast Implant Flipping?

There are various causes for why your breast implants may flip after your breast enhancement surgery. Causes for breast implant malrotation can include:

1. Breast Trauma

If you endured any type of trauma to your breast implants, be it during a sporting activity, accident, or otherwise, your breast implants may move out of their original place. They can flip upside down or rotate 180 degrees from back to front.

2. Insufficient Post-operative Rest

You may be excited to show off your new perky breasts right after your boob job and recovering from breast surgery can be a tedious event, however lack of proper postoperative immobility can prevent proper implant fixation, allowing breast implants to rotate. Avoid vigorous breast massages and overuse of your upper chest muscles until your plastic surgeon gives you the green light to do so.

3. Breast Implant Type

Some breast implant models have a smooth shell and a round profile that make breast implant flipping a more likely occurrence. Here at Coco Ruby, we use state-of-the-art breast implants such as Motiva. And while Motiva is a smooth surfaced implant, it has adhesive surface technology that allows prosthetic fixation to the surrounding tissue. Moreover, unlike their textured counterpart, Motiva causes less inflammation to the surrounding tissue, which can be a reason for capsular contracture, another cause of breast implant flipping. An Anatomical breast implant is more noticeable when flipped than a round implant.

4. Capsular Contracture

After your breast augmentation procedure, your body will naturally form a layer of capsular scar tissue around your breast implant site. Capsular contracture is when your scarring becomes intense, forming a thick and firm layer that squeezes your breast implants, causing chronic pain, and in some cases, back to front, or upside-down breast implant flipping.

5. Large Implant Pocket

During your breast surgery procedure, your plastic surgeon will create a breast pocket beneath your breast mound or chest muscles to place the implants. Regardless of the location, if your breast pocket is too large, your implants will have more room to flip upside down, or mal-rotate back to front. Large implant pockets can be due to other factors, like gravity, lactation, ageing, and tissue factors such as stretching and thinning.

capsular contracture is a risk of surgery

What Does A Flipped Breast Implant Look Like?

It’s important to be able to tell if your breast implants have flipped or not. You may assume it’s a fairly easy task, but that’s not always the case.

Round breast implants can more or less keep their shape despite any direction they are in. They will likely remain unnoticed if they flipped. Luckily, routine imaging studies are recommended after augmentation mammoplasty which can always confirm the position of your implants.

A flipped tear-drop-shaped implant, which mimics the natural anatomic shape of your breasts, is more noticeable. They hold up their shape regardless of their position. So, if tear-drop implant malrotation occurs, you will notice your breast:

  • Looks visually different when compared left to right
  • Feels different to the touch
  • Is no longer symmetrical as when right after your boob job procedure
  • Is causing you discomfort when lying down or standing up

Do Rotated Breast Implants Hurt?

One of the reasons why breast implant malrotation can sometimes remain unnoticed is because they are often asymptomatic. This means, unless trauma or capsular contracture are associated, you will feel no pain whatsoever.

How Are Flipped Implants Diagnosed?

Breast implant flipping is diagnosed clinically by asymmetry or a misshapen breast. It can be self-described by the patient or detected through a proper physical examination by your plastic surgeon.

As mentioned before, round-shaped breast implant malrotation is much harder to recognize, especially if you have ample soft tissue coverage. In these cases, imaging studies such as ultrasounds and magnetic resonance imaging (MRI) are utilized.

Motiva Smooth Silk (MSS) breast implants also have a new technology that incorporates a radio frequency identification device (RFID). It allows for more precise identification of the breast implant position when flipped or displaced.

Is Breast Implant Flipping Dangerous?

Breast implant malrotation may not be a life-threatening occurrence, however, it’s still not something to look forward to after your breast augmentation procedure. Not only can it feel uncomfortable, but it can also have dire cosmetic consequences on your breast appearance.

A flipped breast implant will have its back (and often flat) part facing forward, which can give your breasts a flattened appearance. Your breasts will lose their roundness, especially in the upper poles. In some cases, the edges and contour of your breast implants may be visible. If your breast implant flips and bottoms out as well (dropping low in your breast pocket) you may notice your nipple sitting too high on your breast mounds and poking out of your bra.

How Are Flipped Implants Fixed?

If your breast implants flip, you don’t need to flip out yourself. Several approaches can be taken to fix breast implant malrotation.

1. Manual Re-Flipping

This is a great option if your breast implants only flip on occasion after your breast augmentation surgery. Your plastic surgeon will demonstrate to you the proper way to readjust your implants back into place before you can start easily attempting it at home. It usually involves leaning forward to create space for your implant to move inside your breast pocket, and then using your hands to manually re-flip it from the outside back into position.

2. Revisional Surgery

If breast implant malrotation becomes a constant re-occurring problem, a more invasive procedure should be considered. Breast implant revision surgery can involve breast implant pocket tightening and repair if the cause is solely due to breast pocket over- dissection. In other cases, your breast implants may be too big for your physique, so your implants must be switched to more fitting ones instead. Some patient’s breast malrotation is due to their unique chest anatomy. A chest deformity will require a correctional surgery tailored to meet your needs.

How to Prevent Implant Flipping

They say prevention is better than cure, and breast implant malrotation is no exception. You should always entrust your body to a qualified specialized plastic surgeon that has breast augmentation and breast revision surgeries as a significant portion of their practice.

Here at Coco Ruby, you will have the experience of Melbourne’s greatest specialized plastic surgeons at your disposal. They will combine decades of plastic surgery knowledge with the latest surgical techniques and plastic surgery technology to bring you the best of what breast augmentation mammaplasty and implant revisional surgery have to offer.

Breast implant malrotation after a boob job is not uncommon, even when proper surgical techniques are implemented. And though it can be fixed, it’s still not something you’d want to continue to worry about. That’s why at Coco Ruby we opt to use the best breast implants available in the market to put your mind at ease.

Motiva breast implants are made up of medical-grade silicone, designed to utilize the latest implant technology to mimic both the feel and look of a natural breast. And even though smooth-surfaced implants are more prone to flipping, Motiva is covered with an adhesive outer layer that promotes its fixation to nearby tissue.  It causes minimal inflammation and is thus associated with a reduced risk of capsular contracture.

Moreover, Motiva has the Q Inside® Safety Technology feature, an RFID tool placed in the posterior inner surface of the implant. This can ensure the implants are in their proper position in the breast pocket right after your breast augmentation surgery. This can also be used as a helpful diagnostic tool to detect possible future malrotations as well as the most minimal of displacements.

Is Implant Flipping Covered by Implant Warranty?

Nowadays, many breast implant manufacturers offer standard warranty programs that are cost-free (unless you enroll in a more premium paid program). These warranty programs cover a various array of implant-related adverse effects, such as ruptured implants or capsular contracture. Unfortunately, breast implant flipping and malrotation are not usually one of them.

If you experience any signs of breast implant malrotation, such as discomfort and misshapen breasts, do not hesitate to book a consultation session with a certified plastic surgeon. The reason why you had a boob job in the first place was to have your breasts always looking their best, and breast implant flipping can stand in the way of that. Your plastic surgeon will not only confirm the diagnosis but also determine if further breast revisional surgery is required.

Breast Implant Rotation FAQs – Questions about breast implant flipping and malrotation:

What holds breast implants in place?

  • As your body recovers from its breast enhancement surgery, a scar tissue capsule will form around your implant that holds it in place and prevent a shift in position. Moreover, the same muscles, tissues, and ligaments that support your original breast will also provide the same support to your newly augmented breast.

How often do implants rotate?

  • It’s hard to determine how often a breast implant may rotate when many of the cases go by unnoticeable and are discovered incidentally during a checkup. Some studies have shown it to be around 1 to 14% of boob job cases.

What is bottoming out of the implant?

  • Bottoming out is a form of breast implant displacement. It is when your implant descends below your breast fold crease, causing breast asymmetry.

How often should breast implants be checked?

  • Health authorities advise having your silicone implants screened by MRI three years after your initial augmentation mammaplasty, and every two years after that. This can help detect any implant rupture, malrotation, or displacement. With saline implants, if you are satisfied with how they look and experiencing no problems, you can get them checked every five to ten years after surgery. Textured implants require more regular screening.

References and Medical Sources:

Last updated: 30/08/2021
Author profile image
Dr Craig Rubinstein - MBBS, FRACS (Plast)
Dr Craig Rubinstein MBBS, FRACS (Plast), a Specialist Plastic Surgeon, is one of Australia's most respected Melbourne Surgeons for Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction surgery and Abdominoplasty procedures. Using advanced surgical techniques to gain better body contouring and natural-looking surgical results, Dr Rubinstein is highly regarded by peers and patients for best-practice Clinic Patient-care and patient education strategies. He published a chapter on corrective surgery for Breast Asymmetry. Qualifications/Training Fellow of the Royal Australasian College of Surgeons (FRACS) The Australasian Society of Aesthetic Plastic Surgery (ASAPS) The Australian Society of Plastic Surgeons (ASPS) The Australian Medical Association (AMA) American Society of Plastic Surgeons (ASPS) The International Society of Aesthetic Plastic Surgeons (ISAPS) Founder: Coco Ruby Plastic Surgery previously Cosmetic Surgery for Women and Men Bio Page: https://cocorubyplasticsurgery.com.au/dr-craig-rubinstein-plastic-surgeon/

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Disclaimer: Results depend on individual patient circumstances and can vary significantly. Results may also be impacted by a variety of factors including your lifestyle, weight, nutritional intake and overall health. Consult your Specialist Plastic Surgeon for details. This information is general in nature and is not intended to be medical advice nor does it constitute a doctor-patient relationship. Surgery risks and complications will be covered in detail during a consultation with your Surgeon.