Breast Implant Displacement (Malposition)
Overview
- Breast implant displacement occurs when an implant shifts, moving out of its intended position.
- Although certainly not an expected or desirable outcome of breast augmentation, any breast implant can shift, be it saline or silicone.
- Sometimes the issue is purely cosmetic, but it can be uncomfortable or painful.
- Plastic surgeons can correct a displaced implant, but exactly how they do so varies based on the reason for the shift.
What Is Breast Implant Displacement?
Breast implant displacement, also called breast implant malposition, occurs when an implant shifts or moves out of its proper position within the breast pocket. It can happen in one or both breasts and has no timeline — it can happen shortly after your breast augmentation or many years later. Displacement can affect all types of breast implants, so saline, silicone, and gummy bear implants can all be subject to malposition. If your implants are displaced, you may experience changes in breast shape, new asymmetry, a change in where the breast sits, and a difference in the way your breast feels.
What Breast Implant Malposition Is Not
A shift in implant location doesn’t necessarily mean that you’re experiencing implant displacement. As you recover from your breast augmentation surgery, your implants will settle a bit as you heal and your breast tissue adapts to your new size. This is normal and not a sign of displacement.
There are also a few conditions that can cause changes in an implant’s location and shape that are separate and distinct from implant malposition. These include:
- Capsular Contracture: Scar tissue buildup within the breast pocket squeezes the implant, leading to firm, tight, distorted, and potentially painful breasts.
- Implant Rupture: Damage to the breast implant causes it to leak or flatten, changing the look and feel of the breast.
- Natural Breast Sagging: The breasts continue to age after an augmentation, and some natural sagging and shifting can result. Generally, natural sagging takes the nipples along with the breast tissue, keeping them fairly centered over the lower breast mound.
Types of Breast Implant Displacement
Plastic surgeons describe breast implant malposition in different ways based on what direction the implant moves when it shifts. There are several different types of implant displacement.
Bottoming Out
When an implant bottoms out, it drops to the bottom of the breast, below the crease where the breast meets the chest wall (known as the inframammary fold). The lower portion of the breast may look overly full or elongated, and the nipple can appear to sit unusually high as the implant shifts beneath it. Large implants, pregnancy, and age-related skin laxity increase the risk of an implant bottoming out.
Lateral Displacement
Lateral displacement occurs when a breast implant moves outward toward the outside of the chest or armpit. This makes the breasts look unusually far apart, especially when you lie on your back. This type of displacement is often caused by an oversized or stretched implant pocket.
Medial Displacement and Symmastia
The opposite of lateral displacement, medial displacement happens when the implant shifts toward the center of the chest, moving towards the other breast. If severe enough, this malposition can cause symmastia, a condition in which the breasts appear to be connected across the sternum. Think of symmastia as a unibrow for your breasts.
High-Riding Breast Implant
Exactly what it sounds like, high-riding breast implant displacement is when the breast implant sits too high on the chest. This can happen when the implants don’t settle properly after your breast augmentation but can also happen if the implants shift upward later. The result is excess upper pole fullness coupled with inadequate lower breast volume.
Implant Rotation
Sometimes breast implants rotate within the breast pocket. This may not be problematic with round implants but can create quite a bit of distortion when a teardrop (anatomical) implant shifts. Some gummy bear implants are anatomical implants, so this particular displacement is more likely to be an issue with silicone or gummy bear implants than others.
Signs and Symptoms of a Displaced Breast Implant
Sometimes breast implant displacement is purely a cosmetic concern, but it can cause pain, pressure, or a pulling sensation. Pain and persistent discomfort can indicate that your implant has shifted, and they’re also two issues you don’t need to accept or learn to live with. If your implants feel different, cause discomfort, or hurt you, talk to a doctor or plastic surgeon to find out why and how to correct the situation.
Cosmetic malposition issues are also a valid concern, even if your breasts aren’t painful or uncomfortable. Visible signs of implant displacement include:
- One breast suddenly sitting higher or lower than the other
- A slow shift in position, resulting in one breast sitting higher or lower than the other over time
- Increasing breast asymmetry
- An implant appearing too close to the armpit
- An unusually wide gap between the breasts
- The breasts appearing too close together
- The nipple appearing too high, low, or off-center relative to the breast mound
- An implant’s outline becoming more visible
- A breast developing an unnatural or distorted shape
- A previously stable result changing over time
What Causes Breast Implant Malposition?
Breast implant displacement generally reflects the interaction between the implant, implant pocket, and the patient’s supporting tissues rather than one single cause. Implants don’t randomly decide to wander. Instead, scarring, the breast pocket, soft tissue around the breast pocket, chest anatomy, and gravity usually lead to shifts in implant position.
There are some risk factors that may increase the likelihood that your implants will move or shift. Potential risk factors include:
- An oversized or inadequately secured implant pocket
- A large implant too heavy for the available tissue support
- Thin or weakened breast skin
- Aging and gravity
- Pregnancy and breastfeeding
- Significant weight changes
- Chest trauma
- Returning to activity too early in breast augmentation recovery
- Previous breast surgeries or revisions
How Is Breast Implant Displacement Corrected?
There are a number of options available for correcting breast implant displacement, and the best one depends upon the type of displacement and the reasons for it. Breast implant revision surgery is usually necessary, but it’s important to be evaluated by a plastic surgeon before assuming you’ll need another procedure. If you do require revision surgery, it may involve:
- Adjusting the existing implant pocket
- Reinforcing the existing pocket
- Creating a new implant pocket
- A breast lift to correct sagging skin and breast tissue
- Fat grafting if the edges of the implant are showing
Sometimes the breast implants are changed during revision surgery. Smaller implants may be selected, for example, if the weight of the implants contributed to the implant displacement. This gives you an opportunity to go from saline implants to silicone and vice versa. Your plastic surgeon may encourage you to replace your implants with a different size, firmness, or projection to prevent future displacement.
Recap
Breast implant displacement or malposition means the implant has moved outside its intended position. The direction in which the implant moves varies, and the correct treatment depends on how and why the implant shifted. As such, there are many possible ways to fix the problem, and your plastic surgeon can help you find the right solution for you. Sometimes breast implant displacement is mild, but don’t let that discourage you from reaching out if you have an issue. You know your body better than anyone, so trust your instincts. If it feels like things are shifting, they probably are.
Frequently Asked Questions
New implants may shift slightly as you heal from surgery and swelling abates, but an established breast implant that has moved out of position isn’t likely to move back on its own. When an implant shifts, there is always a reason. Correcting that underlying issue is the only way to put your implant back where it belongs.
Generally, no. But we do advise you to schedule a consultation if breast implant malposition is bothering you physically or emotionally. Seek help quickly, however, if you experience severe pain, marked swelling, redness, trauma, fever, or other abrupt breast changes. These can be signs of other complications or problems that you need to address.
No, but… During your initial breast augmentation recovery you will need to wear a supportive surgical bra. If you don’t, or if you resume activity before being cleared by your plastic surgeon, you increase the risk of implant displacement. Be sure you follow all of your post-op instructions closely and carefully.
Once your implants have stabilized after your breast augmentation, exercise alone shouldn’t displace them. But if you return to strenuous upper-body exercises too soon after your initial breast augmentation, you could place stress on the healing tissue, allowing your implants to shift. You may notice that under-the-muscle implants move temporarily during certain chest movements, but if they return to their normal position after the movement is completed, then you aren’t experiencing breast implant malposition.
Yes. Revision can correct malposition but cannot eliminate all future risk. Previous scar tissue, tissue quality, implant size, and repeated surgery may affect long-term pocket stability.
Your health insurance could potentially cover your revision surgery if correction is deemed medically necessary. Coverage varies from one insurer to another, so you’ll need to talk to your insurance company. Mia Aesthetics does not accept health insurance. If your insurance is willing to cover your surgery, you may need to pay us for your surgery and then work out a reimbursement program with them.