Implants can shift position from their intended location, a phenomenon known medically as implant malposition. The question of whether a breast implant can shift position is a common concern for individuals considering or having undergone augmentation. This movement is categorized into two distinct forms: displacement and rotation. Understanding these movements is the first step in addressing the issue, as each type has different visual effects and corrective strategies.
Defining Implant Displacement and Rotation
Implant movement is separated into two distinct categories based on how the device changes position. Displacement, or migration, occurs when the entire implant shifts away from its optimal surgical location, moving either laterally toward the armpit or inferiorly toward the abdomen. A common type of displacement is “bottoming out,” where the implant moves too far down, causing the nipple to appear unusually high on the breast mound. Another form, symmastia, occurs when the implants move toward the center, eliminating the cleavage line between the breasts.
Rotation, in contrast, involves the implant spinning on its central axis within the established pocket. This is primarily a concern with anatomical, or teardrop-shaped, implants, which are designed to maintain a specific orientation. Because round implants are symmetrical, rotation does not typically alter the breast shape. However, if a shaped implant rotates 90 or 180 degrees, it can result in a noticeable distortion of the breast contour.
Factors That Cause Movement
The stability of a breast implant is directly related to the integrity and size of the surrounding tissue pocket created during surgery. A primary mechanical cause of movement is an implant pocket that is initially too large for the device, allowing it excess room to shift or rotate. Over time, factors like the weight of a large implant can also stretch the pocket and weaken the surrounding tissues, leading to progressive downward or lateral migration.
Another factor is the formation of a tightened scar capsule around the implant, a condition called capsular contracture. As this fibrous tissue hardens and contracts, it can squeeze the implant, forcing it out of its correct position. This mechanical pressure can lead to displacement, often causing the implant to ride high on the chest wall. Trauma or early strenuous activity, such as heavy lifting or intense upper-body exercise, can also physically dislodge the implant before the capsule has fully stabilized.
Implants placed beneath the pectoralis major muscle (sub-muscular placement) are susceptible to a type of movement known as dynamic displacement. When the chest muscle contracts, it can exert force on the implant, sometimes causing it to be pushed downward or outward. This effect, often called “implant animation,” can be visibly noticeable during activities like pushing or lifting and may contribute to movement over time. The type of implant surface can also play a role, as smooth implants generally have a greater tendency to move compared to their textured counterparts.
Symptoms and Surgical Correction Options
A shifting implant is most often noticeable through a visible change in the breast’s appearance, resulting in asymmetry in shape, size, or position compared to the other breast. Specific signs of displacement include the implant edge becoming visible or palpable in new areas, or the development of visible rippling or wrinkling on the breast surface where the tissue coverage is thin. Rotation of a teardrop implant typically presents as an unnatural shape, such as a breast that appears top-heavy or where the nipple points in an incorrect direction.
Correction of implant malposition almost always requires a secondary surgical procedure, known as a revision surgery. For displacement, surgeons often perform a capsulorraphy, which involves tightening or resizing the existing implant pocket with internal sutures to physically restrict movement. In cases of bottoming out, where the implant has dropped too low, an internal bra technique may be employed, using strong sutures or supportive mesh materials to anchor the inframammary fold (the crease beneath the breast) to the chest wall.
To address rotation, especially with anatomical implants, the surgeon may exchange the implant for a different type, such as a round implant, or use a textured shell designed to adhere better to the surrounding capsule. For dynamic displacement caused by muscle contraction, the solution may involve changing the implant location from sub-muscular to sub-glandular (above the muscle) to remove the dynamic pressure. In some instances, the best course of action is a complete implant exchange, allowing the surgeon to create a new, appropriately sized pocket and replace the device.
Post-Surgical Stabilization and Monitoring
Maintaining implant stability relies on adherence to post-operative instructions, particularly during the initial healing phase. Patients are instructed to wear a specialized medical compression garment or supportive bra continuously for a specified period. This garment minimizes implant movement and holds the device securely while the surrounding scar capsule forms and matures.
Activity restrictions are paramount in the weeks following the procedure to prevent trauma or force from disrupting the healing pocket. Avoiding strenuous activities, heavy lifting, or exercises that intensely engage the chest muscles is necessary until cleared by the surgeon. Some surgeons recommend specific implant displacement exercises, which are gentle movements designed to keep the pocket flexible and discourage a tight capsule.
Long-term stability is supported by routine self-monitoring and regular consultations. Patients should perform periodic self-checks to notice subtle changes in breast contour, firmness, or symmetry. Promptly reporting unusual pain, lumps, or abnormal movement allows for early detection and intervention.