Getting breast implants is a significant decision for many women, aiming to enhance their appearance and boost self – confidence. However, a distressing issue that some women may encounter after breast augmentation is the sensation of their breast implants moving. This not only causes physical discomfort but also a great deal of psychological stress. In this article, we will explore in detail the causes behind this phenomenon and the available solutions.
Understanding Breast Implants
Before delving into the problem of moving implants, it’s essential to have a basic understanding of breast implants. There are two main types of breast implants: saline and silicone. Saline implants are filled with sterile salt water, while silicone implants are filled with a silicone gel that mimics the feel of natural breast tissue.
Saline Implants
Saline implants have been used for a long time. They are often preferred because they are less expensive and, if they rupture, the saline solution is harmless to the body and will be absorbed. However, they may feel slightly less natural than silicone implants, especially when the fill volume is low.
Silicone Implants
Silicone implants are known for their more natural feel and appearance. They are available in different gel consistencies, from highly cohesive “gummy bear” implants to more traditional silicone – filled ones. These implants tend to maintain their shape better and are less likely to wrinkle or ripple under the skin.
Causes of Breast Implant Movement
Surgical Technique
Incorrect Pocket Placement: One of the most common surgical – related causes of implant movement is incorrect pocket placement. When the surgeon creates a pocket for the implant either too large or in the wrong anatomical position, it can lead to the implant shifting. For example, if the submuscular pocket (the space created under the pectoralis major muscle) is made too wide laterally (towards the armpit), the implant may slide towards that side. This can happen because there is not enough tissue or muscle support to hold the implant in its proper position.
In some cases, if the surgeon does not accurately define the boundaries of the pocket during a subglandular implantation (placing the implant above the muscle but under the breast tissue), the implant may move around within the loose space.
Insufficient Fixation: Another surgical factor is insufficient fixation of the implant. After placing the implant in the pocket, if the surgeon does not take proper steps to secure it in place, the implant can move. This could be due to not suturing the pocket walls tightly enough around the implant or not using additional fixation methods such as mesh in cases where extra support is needed.
Tissue Changes
Muscle Activity: The pectoralis major muscle plays a significant role in the stability of breast implants, especially in submuscular implantations. Excessive muscle activity can cause the implant to move. For instance, women who engage in strenuous upper – body exercises like weightlifting or certain yoga poses that involve a lot of chest muscle contractions may experience implant movement. When the pectoralis major muscle contracts, it exerts pressure on the implant. If the implant is not properly secured, this repeated pressure can gradually push the implant out of its original position.
Aging and Weight Fluctuations: As a woman ages, the natural breast tissue undergoes changes. The skin loses elasticity, and the breast tissue may atrophy. These changes can affect the position of the implant. Additionally, significant weight fluctuations can also impact the stability of the implant. Rapid weight loss can lead to a decrease in the amount of surrounding soft tissue, which may no longer provide enough support for the implant, causing it to move. On the other hand, rapid weight gain can stretch the skin and surrounding tissues, creating a looser environment for the implant to shift.
Capsular Contracture
What is Capsular Contracture
Capsular contracture is a complication that occurs when the scar tissue (capsule) that naturally forms around the implant tightens and squeezes the implant. In some cases, this can also cause the implant to move. The tightening of the capsule can create uneven pressure on the implant, forcing it to shift to a different position.
Causes of Capsular Contracture: Infection during or after the surgery is a major risk factor for capsular contracture. Bacteria can enter the surgical site during the operation or through the incision after surgery. Even a small amount of bacteria can trigger an immune response, leading to the formation of a thick, tight capsule around the implant. Another cause is a hematoma (a collection of blood) that forms around the implant. This can also stimulate the body’s inflammatory response, increasing the likelihood of capsular contracture.
Implant – Related Issues
Implant Rupture: If an implant ruptures, it can cause the implant to move. In the case of saline implants, when the shell breaks, the saline solution leaks out, and the deflated implant may shift within the pocket. For silicone implants, a rupture can cause the gel to spread, which can also affect the position of the remaining intact part of the implant or the overall shape and stability of the breast.
Implant Design and Quality: The design and quality of the implant can also contribute to movement. Lower – quality implants may not have the proper structural integrity to maintain their position over time. For example, some implants with thinner shells may be more prone to movement as they are more easily affected by external forces such as muscle contractions or tissue changes. Additionally, implants with improper sizing or shape for the patient’s body can also lead to movement issues.
Effects of Breast Implant Movement
Aesthetic Concerns
Asymmetry: One of the most noticeable aesthetic effects of implant movement is breast asymmetry. When an implant moves, it can cause one breast to appear higher, lower, or in a different position compared to the other. This can be very distressing for the patient, as the goal of breast augmentation is often to achieve a more symmetric and aesthetically pleasing appearance.
Abnormal Shape: The movement of the implant can also distort the shape of the breast. The implant may shift in a way that causes the breast to look misshapen, with lumps, bumps, or an unnatural contour. This can be especially noticeable when wearing tight – fitting clothing or in certain postures.
Physical Discomfort
Pain: Implant movement can cause pain, especially if the implant is rubbing against surrounding tissues or muscles. The friction created by the moving implant can irritate the skin, breast tissue, and muscle, leading to discomfort that can range from a mild ache to severe pain. In some cases, the pain may be constant, while in others, it may be triggered by movement, such as when raising the arms or bending over.
Pressure Sensation: Patients may also experience a pressure sensation in the breast area. This can be due to the implant pushing against the chest wall or other structures in an abnormal position. The pressure can be uncomfortable and may also affect the patient’s ability to perform normal activities, such as lying on their chest or wearing certain types of bras.
Psychological Impact
Anxiety and Self – Consciousness: The physical changes caused by implant movement can have a significant psychological impact on the patient. Women may become extremely anxious about the appearance of their breasts and may feel self – conscious in social situations. This can lead to a decrease in self – esteem and confidence, affecting their overall quality of life.
Body Image Disturbance: The unexpected change in the appearance of their breasts can also cause body image disturbance. Patients who have undergone breast augmentation often have a certain image of themselves in mind, and when the implants move and disrupt that image, it can lead to feelings of dissatisfaction and even depression.
Solutions for Breast Implant Movement
Surgical Revision
Repositioning the Implant: In many cases, the first step in addressing implant movement is surgical revision to reposition the implant. The surgeon will carefully open the original incision (or make a new one if necessary) and re – establish the correct pocket for the implant. This may involve tightening the pocket walls, removing any excess tissue that may be contributing to the movement, and re – suturing the implant in place. For example, if the implant has moved laterally, the surgeon will create a new, more appropriately sized pocket towards the center of the chest and secure the implant in this new position.
Changing the Implant Type or Size: Sometimes, the cause of the implant movement may be related to the type or size of the implant. In such cases, the surgeon may recommend changing the implant. For instance, if a patient has a saline implant that is constantly moving due to its light weight and lack of stability, the surgeon may suggest switching to a silicone implant, which is generally more stable and has a better natural feel. If the implant is too large for the patient’s body and is causing movement due to excessive pressure on the surrounding tissues, downsizing the implant may be an option.
Using Fixation Methods: To prevent future movement, the surgeon may use additional fixation methods during the revision surgery. One common method is the use of mesh. The mesh is placed around the implant or along the pocket walls to provide extra support and stability. It acts like a scaffold, holding the implant in place and preventing it from shifting. Another fixation method is the use of specialized sutures or adhesives to secure the implant more firmly within the pocket.
Non – Surgical Management
Physical Therapy: In some cases, especially when the implant movement is due to muscle imbalance or over – activity, physical therapy can be beneficial. A physical therapist can design a personalized exercise program to strengthen the muscles around the chest in a balanced way. For example, specific exercises can be prescribed to strengthen the pectoralis minor muscle, which can help counteract the forces that may be causing the implant to move. Additionally, the physical therapist can provide guidance on proper body mechanics and movement patterns to avoid putting excessive stress on the implants.
Wearing Supportive Garments: Wearing a well – fitted, supportive bra can help reduce the movement of the implant. A good – quality sports bra or a specialized post – surgical bra can provide extra support to the breasts, keeping the implants in a more stable position. These bras are designed to distribute the weight of the breasts evenly and minimize the impact of movement on the implants. Some bras may also have additional features such as wide straps and underwire for added support.
Monitoring and Follow – Up
Regular Check – Ups: Whether a surgical or non – surgical solution is chosen, regular check – ups with the plastic surgeon are crucial. The surgeon can monitor the position of the implant, check for any signs of further movement or complications, and make adjustments to the treatment plan if necessary. During these check – ups, the surgeon may use imaging techniques such as ultrasound or MRI to get a detailed view of the implant and the surrounding tissues.
Patient Education: The plastic surgeon also plays an important role in patient education. Patients should be informed about the signs and symptoms of implant movement, as well as how to take care of their implants to minimize the risk of movement. This includes advice on diet, exercise, and proper breast care. For example, patients should be aware that sudden weight changes should be avoided, and they should follow a gentle exercise routine that does not put excessive strain on the chest muscles.
Conclusion
Experiencing the sensation of a breast implant moving can be a distressing and concerning issue for women who have undergone breast augmentation. Understanding the causes, such as surgical technique, tissue changes, capsular contracture, and implant – related problems, is the first step in finding an appropriate solution. Whether it’s through surgical revision, non – surgical management like physical therapy and wearing supportive garments, or close monitoring and follow – up, there are ways to address this problem. It’s important for patients to communicate openly with their plastic surgeons and seek prompt medical attention if they suspect that their breast implants are moving. By taking these steps, women can hope to regain the aesthetic appearance and comfort they desired when they decided to undergo breast augmentation.
Remember, each case of breast implant movement is unique, and the best approach to treatment will depend on the individual patient’s circumstances. So, if you are facing this issue, don’t hesitate to consult with a qualified and experienced plastic surgeon who can provide you with personalized advice and the most suitable treatment options.
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