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A term that is being used in association with breast implants and which, until fairly recently, has attracted little attention, is “flipped” (or “flipping”).

As in “implant flipping”.

Even now, few people have heard this term used or know what it even represents.

That is a good thing since we don’t want this to be a very common occurrence. However, like many things in life, with improvements and technological advancements, there often are downsides or risks.

This applies to breast implants as well, unfortunately, and why “implant flipping” may become the next “thing” or topic of discussion including when considering silicone breast implants for a breast augmentation or breast reconstruction.

What is breast implant flipping?

Breast implant flipping is the situation where an implant rotates front to back (or anterior to posterior) 180 degrees. Visualize flipping a hamburger or pancakes while you are cooking them.

That is flipping. It is as simple as that.

Of course, you want to flip your hamburgers or pancakes but you do not want to flip your implants.

Nor cook them!

How common is it for an implant to flip?

It is not accurately known how common it is for breast implants to flip though numbers from 1% to 14% have been mentioned. One of the major reasons for this, at least until the most recent generation of form-stable highly cohesive gel breast implants became available, is that it was virtually impossible to discern this occurrence most of the time. In the past, both the saline and silicone implants were generally soft and malleable so that when they would flip, their contour would largely adjust so it would difficult to detect any difference in overall breast shape. Most of the time this would be discovered at the time of either a breast implant exchange or explantation when the removed implant would be noted to be situated upside-down in the “pocket” in the breast.

Is this a dangerous problem?

Having a flipped or flipping implant (just had to say that!) presents no danger whatsoever. At most, it is an aesthetic issue which may or may not be subtle. If the change in appearance is significant or dramatic then you would want to address it – either by manipulation or possibly even surgery.

Does it hurt?

A flipped implant is asymptomatic. There is no pain whatsoever. In fact, many women who have it may either not notice anything or just see a little difference in appearance and may wonder why that is.

What does a flipped implant look like?

Unlike hamburgers or pancakes, implants don’t have the exact same shape on both “sides”. The breast implant has a flat base which rests either on the chest wall when placed in a submuscular position or on the pectoralis major muscle when placed in a submammary position. Arising from this base is the round, projecting portion that is filled either with silicone or saline.

So, one side is flat and the other is round so their appearance would be different depending which side was facing up (photo A).

Visualize an orange cut in half. Lay one half down on the exposed juicy part and the other half on the peel – next to it. Notice the difference in contour facing up. Now you have the fruit version of a flipped implant.

A) These are the exact same size and profile implants. The one on the right is “flipped”. Note the big difference in shape and appearance between the two implants.

The following photos show a breast reconstruction patient who woke up one morning and noticed that her left breast looked different from before. Examination revealed that the implant did indeed flip giving the breast a flattened appearance (photos B and C).

B) Normal left reconstructed breast

C) After left breast implant flipped

Can it be fixed?

Yes, a flipped implant can be fixed – often with some careful, strategic manipulation. Initially, your plastic surgeon should do it in the office. He/she can also discuss with you how to address it if it occurs again. This way you can fix it yourself.

In the above patient, her flipped implants was addressed by breast and implant manipulation at the time of her visit with the results being immediate and obvious (photos D and E)

D) After left breast implant flipped

E) After corrective manipulation

If this becomes a frequent issue or just a nuisance, then surgical options can be considered.

In later blogs, I will discuss more on this issue including why it can occur, why we are seeing more flipped implants now and various considerations as well as available surgical options.

 

For more information on breast implants, breast surgery or other plastic surgery procedures or to schedule your consultation, you can call my office at (480) 451-3000 or email us.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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