How To Manually Flip A Breast Implant -

Getting the correct fit for a breast implant is important for both comfort and safety. Some women may experience complications with their implants if they are flipped or upside down. This occurs when a small pocket is created, which causes the implant to become pressured and flip inside the pocket. It can be an uncomfortable feeling, but there are ways to alleviate this problem.”

In this guide, we review How To Manually Flip A Breast Implant, what does a flipped implant look like, can breast implants flip around, and breast implant manipulation.

How To Manually Flip A Breast Implant

A woman may find that her breast implant is flipped or upside down. This can happen when the pocket within the breast that houses the implant is too small. When the pocket is made smaller, it places pressure on the implant, and the implant flips inside the pocket.

The following are some of the signs that a woman may be experiencing a flipped implant:

A woman may find that her breast implant is flipped or upside down. This can happen when the pocket within the breast that houses the implant is too small. When the pocket is made smaller, it places pressure on the implant, and the implant flips inside the pocket.

If a woman finds that her breast implant is flipped or upside down, it’s likely because the pocket within the breast that houses the implant was made too small. When this happens, pressure is placed on the implant and it flips inside of your body. The result is an implant that looks as though it’s upside down or sideways. This can be corrected by manually flipping over your breast implants.

Manually flipping over a flipped breast implant involves making an incision around each side of your nipple and lifting up on each side to lift out each individual implant from its pocket in order to flip them back into place. Once you’ve successfully turned both implants over, you’ll need to close any incisions made around your nipple area and bandage these closed so they heal properly before moving forward with any additional steps needed after having manually flipped over a flipped breast implant

The following are some of the signs that a woman may be experiencing a flipped implant:

Pain in the breast
Difficulty finding a bra that fits properly
Difficulty finding clothes to fit over the breasts, especially when lying down or sitting on something hard, like a chair seat.
Discomfort lying on her chest while sleeping or exercising.

pain in the breast

As with any other surgery, there are risks of infection and bleeding. The risk of infection is low because the procedure doesn’t require any incisions in your body. You may experience some bruising and swelling, which should go away within a few weeks.

Your breast will feel stiff and hard for several days following the implant flip, but it should soften over time as inflammation subsides and fluid drains from your breast pocket (indentation where an implant sits).

You may experience pain in your breast after surgery—this is normal while you heal! You can take acetaminophen (Tylenol) or ibuprofen (Advil) to manage discomfort until it goes away on its own (usually within 1-2 weeks). Pain that lasts longer than 2 weeks could be a sign of capsular contracture; talk to your doctor about what this means for you if that’s happening.

difficulty finding a bra that fits properly

The size of your breasts is determined by the volume of fat, breast tissue and skin contained within them. The number you see on most bras represents the size of your ribcage in inches, usually around where your underbust is. If you find yourself saying “I’m a 34C,” then chances are that’s where your ribs start—which means that all other sizes are based off this ratio.

So how do we determine what size our breasts actually are? And how do we know if they’re too big or small for their current bra?

There’s one important thing to remember: bras are made to fit all shapes and sizes, so don’t feel like there are any rules when it comes to buying underwear!

difficulty finding clothes to fit over the breasts

Many women find it difficult to find clothes that fit their new breast size. It can also be challenging to find bras and shirts that accommodate the added volume in the chest area.Many women experience difficulty finding dresses, jackets and sweaters that fit over their implants without looking like they are swimming in them.

discomfort sitting on something hard, like a chair seat

Even if you don’t have a problem sitting on something hard, like a chair seat, the implant may be uncomfortable if it is not in the right position. If this happens, see your doctor to have it flipped manually.

discomfort lying on her chest while sleeping or exercising

This is a common complaint for patients who have undergone breast augmentation. The elevated position of the implant gives it a more prominent appearance, but this also puts more pressure on your chest muscles and skin as you move around. This discomfort can be alleviated by using a soft-cup bra or wearing a supportive sports bra while exercising or sleeping on your back. If you’re having difficulty finding clothes that fit properly over your new breasts, consider shopping to find one with stretchy fabric like lycra or spandex so that it will stretch with you as well!

trouble with physical activity such as jogging, running, etc.

If you experience pain or discomfort when taking part in physical activity, it’s important to know that this is not uncommon. This can also be caused by lying on your chest with your arms above your head and by sitting on something hard like a chair seat.

A woman can talk to her doctor about having a flipped implant. Some treatments include updating the size of an implant or changing an implant’s position within its pocket to make sure it does not flip over again. However, this does not always work for everybody. In these cases, surgery for an implant exchange may be recommended. A consultation with a plastic surgeon will determine if this is necessary in every case.

A flipped breast implant occurs when the implant gets flipped over on its side, creating an unnatural shape. The most common symptoms of a flipped breast implant include:

the appearance that your breasts are uneven
a feeling of tightness or pain in your chest
a lump beneath the skin where the pocket was made for your new implant to sit in (this is called capsulitis)

If you think that you may have a flipped breast implant, schedule an appointment with your plastic surgeon immediately. However, if you are dealing with any pain or discomfort from capsulitis and want relief fast, there are several ways to flip back the implant yourself at home using techniques similar to those used by surgeons during surgery for an exchange surgery.

what does a flipped implant look like

There are many mysteries and misconceptions around breast implants, but two of the most common questions that have been coming up lately in my practice are rippling and flipping. Here rippling and flipping implant questions are answered.

Rippling describes seeing the folds of the implant through the overlying mastectomy skin (in reconstruction) or breast tissue (in augmentation). It can happen with either saline or silicone implants, though it tends to be more pronounced with saline implants. More cohesive/ ”gummier” implants are less likely to ripple because they hold their shape better in the body and are firmer, so the implant folds are less prominent. Although rippling is talked about more frequently in discussions of over-the-muscle reconstruction, it can happen with either over-the-muscle or under-the-muscle reconstruction.

When rippling occurs, several different approaches may help improve it. Switching out implants to more cohesive implants can work well. Sometimes, implants may also need to be exchanged for larger ones to help fill out the skin envelope better, which can reduce the appearance of rippling. Putting in a biologic mesh that will help stabilize the implant and/or add a little thickness to the tissues can also help. And finally, fat grafting may also be an effective option for some women to help camouflage the rippling by adding volume to the tissue over the areas of rippling.

Implant flipping (or malrotation) is often thought of as a potential complication of shaped/teardrop implants, occurring when the pocket was too large for the implants, giving them room to rotate clockwise or counter-clockwise, thus distorting the breast shape. More commonly, now, though, is the issue of front-to-back flipping, which happens most frequently with larger, higher-profile/projecting gummy implants. The basic thought is that the implants are essentially top-heavy, and in certain positions (typically when women are lying on their sides sleeping), the pocket opens up in such a way that the implant has room to flip over on itself. This complication is usually instantly apparent to women because the back/flat part of the implant is now facing forwards. When this happens, it gives the breast a flattened appearance with loss of roundness, seen particularly in the top part of the breast. The edges of the implant may also be more prominent or even visible.

Since gummier implants can be very helpful for minimizing rippling and helping with breast shape (particularly in reconstruction), the trade-off of potential intermittent implant flipping may be worth it in some cases. When implant flipping does occur, it can usually be fairly easily flipped back by women themselves, typically by leaning forward and making space for the implant in the pocket to allow for manual flipping back into place.

can breast implants flip around

What in the World? What Does a Flipped Implant Look Like?

The story was similar each time. They would say they noticed a strange contour to their breast, with a flatter contour on top with a square-like ridge often also noticeable. Many of the patients also reported feeling a strange sensation as they were bending over. Many related that they were bending over and felt a swoosh. All of these patients had implant inversion or a flipped breast implant. In other words, their implant was upside down, with the smaller rounded top contour of the implant on the chest wall side, and the flatter, bigger bottom side of the implant facing up.

Things Are Upside Down!

Now when the first patient called, she did not know what was going on. And at first, I suspected it, but kept it to myself, just advising the nurse to have the patient come in to see me. When she arrived and I could clearly see the inversion, I could hardly believe my eyes. With a few firm manipulations, I was able to flip the implant back to its proper orientation but began to wonder what to do to prevent this.

Over the next few weeks to months, it happened again with another patient. And then again and again. In the beginning, they were all breast augmentation revision cases. I suspected the pocket was larger and this was a likely reason it occurred. But then I had some of my primary breast augmentation patients experience this as well. So now, a full 6 months after first seeing this in my practice, I have come to realize, that implant inversion is a real phenomenon, and prevention diagnosis and management are crucial factors to understand.

Head Over Heels: Implant Malposition

At first, I was perplexed— how and why does this happen? When it was only my revision breast augmentations that experienced this strange situation, I believed since their pocket was larger, or if some of the capsule was still intact and well-formed, this slippery inside layer would make it more likely for this to occur. But is it more than just the pocket? After all, the capsule is always quite a bit larger than the implant.

Are High-Profile Cohesive Gel Implants the Common Denominator?

So the cause of implant flipping must be more related to the product—the implant—than the patient’s capsule. And it has to do with the new cohesive gel implants that are higher profile. The base of these implants is wider than the top and heavier. So when the patient bends over in the shower to grab the shampoo, the implant just flips “head over heels,” so to speak. When the implants were less cohesive, lighter, and lower, more rounded profiles, there wasn’t an issue with this. The implants had a back and front, but if it flipped, it was not as noticeable.

Nothing Is Ever New in Plastic Surgery

Some of us plastic surgeons who have been around for 20 or so years will remember the first generation of shaped implants with a teardrop or anatomical contour. These implants had more projection in the lower pole than the upper pole, thus the term “anatomical.” In the photo below, the anatomical implant is pictured on the right.

These implants also were always textured to keep them in the correct orientation. The lower pole with the higher projection needed to stay put in the lower pole, so the implants were textured to get them to stick on the inside. I was one of the plastic surgeons doing this style of implant in the late 1990s and liked the concept of the teardrop shape.

But I had a few patients for whom the texture did not promote sticking, and the implant behaved like a smooth implant. This led to breast implant malposition, as previously described. I switched to using only smooth round implants around the year 2000, since this surface eliminated a variable that I could not control every time. More recently, textured implants have been associated with a condition called BIA-ALCL, and have been removed from the market. So a textured surface was not offered on the new highly cohesive implants. (For more information about smooth versus round implants, take a look at my related blog post.)

Best of Both Worlds

So is there a way to get the benefits of the cohesive gel and the projection of the extra high profile without worrying about implant inversion or flipping? The answer is multifaceted. The easiest response is to say that the pocket has to be tighter. Easy to say, but that is sometimes hard to do. Again, in every patient, the capsule of pocket size is larger than the implant.

Adding to the complexity is the patients who would benefit the most from the extra high profile are often the ones who have had a few children or have lost weight so that the skin envelope is looser to begin with. In these case, we are trying to fill the skin envelope back up again, often on a patient with a very thin torso. The next option is to consider backing down the profile, understanding that this is a tradeoff with the upper pole fullness and size desired by the patient.

This category of patients is already in the most complex type of surgery, and adding another variable can often tip the scales to a point that the risk outweighs the benefit.

The cohesive gel is a game changer when it comes to peace of mind for the patient and me about the future likelihood of implant rupture. I have taken out so many ruptured implants over my career and thought how gooey and unsettling it is, that I was thrilled when the highly cohesive, gummy bear implants were introduced. At last, there was an implant that would not be a sticky gooey mess in the future. So with a cohesive implant removing the possibility of this, it has become the only one I want to use.

This gummy bear level of cohesivity is the game changer. Perhaps it is only the extra high profile implant shape on very lean patients that will have to worry about the inversion. The moderate or full profile implants may be less likely to flip, based on the physics of this shape. But now, with implant inversion as a possibility, it makes it harder to recommend the extra high profile, even when I previously would have.

A Solution?

My idea to solve this would be to add a tab to the extra high-profile implants. This could tack the implant in place and limit the breast implant flipping. So far, this implant does not exist though. In a world turned upside down, my best solution is to hold off on the extra high-profile implants until the tabs are added to the product. Honestly, the difference in profile is measured in millimeters, so for now, I feel that this is an adequate solution.

In summary, this blog explained the phenomenon of implant flipping or inversion and the causes and likely solutions. The best course of action is to seek advice from a board-certified plastic surgeon who has the experience and expertise to guide you in your breast augmentation journey. The entire team at Aesthetica is looking forward to helping you reach for your star. You can schedule a consultation with me by calling my Columbus plastic surgery practice at (614) 569-2649 or by using our online form to request a consultation.

breast implant manipulation

Breast augmentation enhances the size, symmetry, and contour of a patient’s breasts. Many of our patients find that the cosmetic procedure boosts their self-esteem and their bustline.

Following your breast augmentation at our Waukesha, WI, plastic surgery practice, Dr. Tracy E. McCall will provide recommendations on important steps that should be followed throughout your recovery. One key recommendation will be to regularly massage your breasts beginning soon after breast augmentation surgery.

Why Is Massaging My Breasts Important?

The two main benefits of massaging your breasts after breast augmentation deal with implant settling and preventing capsular contracture. Breast massage after augmentation can also shorten your overall recovery time.

Capsular Contracture

Massaging your breasts at regular intervals can prevent the onset of capsular contracture. Although rare, the post-surgical complication causes the soft tissue that surrounds the implants to harden and tighten. Many patients with this complication find that their breasts become painful to touch.

The exact cause of capsular contracture is unknown, but leading theories suggest that the hardening is part of the body’s autoimmune response to the presence of breast implants. Many plastic surgeons, including Dr. McCall, recommend that patients massage their breasts multiple times a day to lower their risk of developing capsular contracture.

Implant Settling

“Drop and fluff” refers to the natural settling process of breast implants once they have been surgically placed. Most patients will notice the dropping phase first before the “fluff” results in the slight expansion of the implants once they have settled.

Having a daily massage routine facilitates and promotes the natural settling of breast implants. Once your breast implants have settled, your breasts will look more natural. This is one reason why we ask patients at our Waukesha office to wait several weeks before they evaluate their cosmetic results. Implants can appear to be unnaturally elevated immediately after surgery.

How to Properly Massage Your Breasts

At the time you are released to return home and recover from your breast augmentation, you will be given instructions on how and when to massage your breasts. Although your breasts will be sore and bruised in the days following surgery, it is best to not wait too long to begin massaging them.

Dr. McCall will give you specific advice on how frequently you should massage your breasts. In general, patients are advised to massage their breasts three times a day for several minutes.

Common Massaging Techniques

Massaging your breasts three times a day during the first month or two while you recover will ensure that your breasts settle properly and do not harden. The following massage techniques are effective and easy to remember.

How To Manually Flip A Breast Implant