The anatomical implant turns over due to a large pocket. Breast plastic surgery: displacements and reversals. Is flipping breast implants dangerous?

Today augmentation mammoplasty is one of the most popular and demanded plastic surgeries among women and girls. With the right approach, the breast after implantation will look great, and the figure will become more feminine. Before deciding to resort to plastic surgery methods, many patients spend hours of their time learning everything about mammoplasty. Particular attention is paid to problems after breast augmentation. One of them is that breast implants are able to turn over after being placed.

Why and when does this happen?

The reasons why an implant rotates can be different. Often this happens due to the fact that the implant is not fixed to the capsule or the dimensions of the latter do not correspond to its dimensions.

Displacement is possible due to severe physical stress, in which the pectoral muscle exerts a mechanical effect on the implants, as a result of which they turn over. Especially often professional athletes and girls who are actively involved in sports suffer from this. Systematic training and intense stress on the muscles of the chest and shoulder girdle can cause rotation. During the recovery period, the rotation of the implant occurs for two reasons:

• refusal or improper wearing of compression underwear, non-compliance by the patient with the recommendations of the doctor;
• Improper formation of the pocket for the implant.

Late displacement most often occurs after trauma: when the patient gets into a traffic accident or falls on the chest.

How dangerous is it?

Most often, anatomical implants are subject to coup. This is due to the fact that they have a displaced center of gravity. Their rotation in any direction is very noticeable, and all because of the special shape of the implant. It is characterized by a flat top and a gradual increase in volume from top to bottom. Often, due to the displacement of prostheses of this form, the patient has to undergo re-correction.

The same cannot be said for round implants. There is an opinion that their reversal will not cause discomfort at all. This is true, but not when its rear and outer surfaces are reversed. This rotation leads to a complete loss of breast shape. It should be noted that correction during implant rotation is not mandatory, since this problem is of an aesthetic nature. If the resulting asymmetry is small, then a second operation can be avoided.

Can the risk of rotation be minimized?

Six months ago, she became an internet sensation when she posted a video of herself putting inverted implants in her butt. And finally, the anonymous owner of the silicone butt showed her face and gave an interview. In the 20-second clip, a woman slowly puts the implants in her buttocks back into place, explaining, “This is my implant flipping back. I don't think an implant should do that. It shouldn't roll over."

Updated on 18/02/13 15:08: Then suspicions arose that this clip was a fake. But consultant British plastic surgeon Adrian Richards said he was sure the clip was genuine. He explained that such a problem occurs when the implant does not sit firmly enough in the "pocket" that the surgeon creates either between the buttocks and the pelvic bone, or on the top of the gluteal muscle. The video really turned out to be real, and the woman who shocked millions of Internet users showed her face and talked about how she had already removed the unfortunate implants, but still feels pain in her lower body. The lady gave her first interview on an American morning TV show. Her name is Rene and she lives in America. The woman admitted that after the operation to install the implants, she began to have big health problems. “Even to the point where I couldn’t breathe at times,” she says.
The popular video was filmed by Renee's friend. The woman just wanted to show her friend what was happening to her. They entered the bathroom, and a friend began to film how Rene inserted the overturned implants into place. Internet users were most shocked by the ease with which she does this. The doctor commented that sometimes the implants turn and snap into place painlessly. However, Renee admits that she was hurt.

Updated on 18/02/13 15:09:

Andrey Firsov, a plastic surgeon, says:

To Like the old “love lecture with slides” joke, today we’re talking about upheavals and displacements. So, flips are different, but in this article we will deal exclusively with the behavior of breast implants.

We will make a reservation right away that we will not consider the situation of the asymmetric position of the implants due to their installation as such, since this is an error during the operation and nothing more.

Implant displacements can be very diverse.

Upshift, as a rule, occurs under the action of the pectoral muscles in a fully axillary setting and is accompanied by the appearance of a waterfall effect - the formation of the so-called double-bubble (photo 1, 2). This, I'm not afraid of this word, vicious technique allows you to hide the implant more deeply in the tissues and in a calm state, the chest looks quite decent, but when the muscles are tense, all beauty comes to naught.

Photo 1: extruding the implant up anddouble- bubblein fully axillary position

Photo 2: waterfall effect when the implant is moved upwards

Or under the pressure of the implant capsule with capsular contracture (photo 3, 4):

Photo 3: bilateral capsular contracture with upward displacement of the implants

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

Photo 4: Implant displacement up and to the side in right-sided mammary fibrosis

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

Offset to the side or down , below the natural submammary fold, as a rule, occurs with a large volume of the implant. On average, the risk increases with volumes over 360-400 ml and / or artificially low submammary fold (photo 5, 6).

The submammary fold is perhaps the most stable and durable component that does not need to be destroyed unnecessarily. And if this is necessary to do, then it must be re-formed with seams. True, as with any rule, there are exceptions, and when placing implants with polyurethane foam coating, it is not necessary to additionally form and strengthen the fold.

Photo 5: implant displacement down on the right, below the submammary fold

Photo 6: the displacement of both implants down, below the submammary fold

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

There are also lateral shifts. , all kinds of coups and rotations of implants, which is more relevant when setting up anatomists (photo 7, 8):

Photo 7, 8: rotation of the anatomical implant on the right

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

There is a myth that overturns are not terrible for round implants. But it is not so. Indeed, the rotation of such an implant does not lead to deformation, but there are also flips “upside down”, when the implant turns over like a pancake in a frying pan, and then the breast loses its shape (photo 9):

Photo 9: overturning, overturning of the round implant

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

The reasons leading to direct displacement, rotation or flipping of implants can be divided into three main groups.

These are factors to consider when planning an operation; direct questions that arise during the operation; and factors that affect the postoperative period.

Factors that can lead to displacement or inversion of the implant include its shape. It's no secret that anatomical implants spin more often. This is due to a displaced center of gravity, especially in high profile implants with a truncated base.

The "poor" texture of the surface of the implants contributes to poor fixation in the tissues and may lead to inversion or displacement in the future (photo 10). The most reliable in terms of fixation are polyurethane foam-coated implants, which are so intimately fixed in the tissues that the frequency of displacement tends to zero.

Photo 10 (left to right): implant smooth without texture, textured, with polyurethane foam coating

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

It is also necessary to take into account the elasticity and turgor of tissues. In women with severe ptosis, multiple striae, thin skin, and significant reduction in breast volume after breastfeeding or after weight loss, the risk of weak fixation and subsequent implant displacement is higher. Therefore, planning for a “skin sheath” lift should be adequate and fit and stabilize the implant as tightly as possible (Figures 11, 12).

Photo 11: pronounced ptosis, multiple striae, reduced turgor and tissue elasticity

Photo 12: pronounced atrophic ptosis, reduced turgor and tissue elasticity

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

There are tricks during the operation aimed at stabilizing the position of the implant. For example, two-plane placement of implants, when the upper part of the implant is located under the gland and under the pectoralis major muscle, and the lower third is only under the gland (photo 13):

Photo 13: biplanar implant placement

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

This approach allows avoiding the "animation" of the chest when the muscles of the chest wall are tense (photo 14), and also allows you to best hide the upper pole of the implant in the tissues and, which is very important, stabilize the position of the implant by pressing it from above, receiving an additional share of the guarantee against its overturning. .

Photo 14: axillary staging, animation distortion of the mammary glands with tension of the pectoral muscles

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

For some types of implants, the site must be tight, or rather exactly match the size and shape of the implant, so as not to give the implant the slightest chance of displacement. First of all, this concerns high-profile anatomical implants with a truncated base filled with a highly cohesive gel.

When forming a larger than necessary bed, the percentage of displacements and flips increases, but with an insufficient bed, situations may arise when the implant is not fully expanded, the edge is broken somewhere or is pressed from one of the poles (photo 15), which, in turn, leads to aesthetic deformations. We can say that the golden mean is good here too.

Photo 15: insufficient bed, underformed lower pole

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

When replacing implants, the old capsule should be removed as much as possible, since the capsule is a smooth, glossy surface, and the fixation of the implant in the old bed is very unreliable.

There are situations when two capsules are formed: one is directly adjacent to the implant, and the second remains in the tissues. Between these capsules there is always a small amount of serous fluid and a kind of articular surface is formed. The implant in such an impromptu joint can rotate completely freely and, as patients say, "the breast changes shape several times a day."

An additional factor that can lead to implant displacement in the future is the high invasiveness of the operation and a large amount of wound fluid in the implant bed. Therefore, during repeated operations, with high bleeding during the operation, drains are necessarily used so that the tissues “hug” the implant as quickly and tightly as possible.

But that's not all. The postoperative period and restrictions in the first 2-3 months after surgery are also important. In the early period, it is mandatory for everyone to wear compression stabilizing underwear for the period of primary fixation of implants, which takes 2-3 weeks (photo 16).

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

Photo 16: compression stockings

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

In the same period, it is impossible to perform torso tilts without supporting underwear. Restriction of physical activity is longer, up to 2-3 months. This is the period of capsule formation, adaptation of the pectoralis major muscle and healing of wound surfaces. During this period, there is a high risk of traumatic ruptures of tissues that have not yet healed and possible displacement of the implant. In the future, there are no restrictions and the frequency of coups and displacements of implants is reduced. But still, in the long term, implant flips occur, which are often associated with excessive physical stress on the upper shoulder girdle.

Unfortunately, there is no 100% guarantee against a coup, but there are very few such cases with proper planning, the use of modern techniques and following the rules after the operation.

Not a public offer! There are contraindications. Before use, a specialist consultation is necessary.

I talk a lot about the benefits of breast augmentation all the time. There are really a lot of them. This type of aesthetic correction of appearance is considered safe and effective today. Thousands of patients have gone through breast augmentation with implants over many years of world practice.

However, it is worth discussing the negative aspects of this correction. Yes, they, unfortunately, exist, but, looking ahead, I will say that these little troubles do not pose a serious danger. So, today we will talk about breast implants, or rather, about their coup inside the mammary glands.

In case of overturning of round implants, there is no need to re-correct

How does this happen?

If rounds are flipped, nothing much happens. More precisely, the patient herself does not feel discomfort. Sometimes a round implant can turn over not along the axis, but along the plane, like a coin. Then there will be a slight asymmetry of the mammary glands. But, as a rule, this option also does not bring much inconvenience. Such asymmetry is perceived as natural, because there are no girls with perfectly symmetrical mammary glands. So in case of overturning of round implants, there is no need to carry out a correction.

The situation is different with teardrop-shaped breast implants. They have a pronounced accent at the bottom, so any displacement of such prostheses will be noticeable. Asymmetry in this case will no longer look harmless, the chest will take on a strange shape. Therefore, girls who are faced with such a problem turn to plastic surgeons for additional correction.

Why does implant displacement occur?

The issue of safety, of course, primarily worries patients and doctors. Many girls get scared if the prosthesis flips over. However, I want to reassure everyone right away. There are no health implications to this. An inverted breast implant is a purely aesthetic problem. Therefore, do not panic. It is important for the patient to simply decide for herself whether such a breast is tired of her, or whether there is still a desire to correct the shape during the second correction.

An inverted breast implant is a purely aesthetic problem.

Many are interested in how often implants flip over. In my opinion, yes. This happens for various reasons. Firstly, as a result of mechanical damage - falls, bumps, injuries. Secondly, the work of the pectoral muscle forces the prostheses to slowly move. This is quite normal, if it does not go beyond the natural asymmetry, which we talked about above.

It is worth noting that this process has a time frame. I'm talking about the fact that in the first months after the operation, the tone of the pectoral muscle is increased, because it is during this period that the implant is likely to shift. Gradually, the tone decreases, and after a year such mild complications become rare. Here I want to note that some time after mammoplasty, there is no visual difference between round and drop-shaped implants.

Therefore, in order to avoid trouble with the rotation of the latter and not face a second operation, it is worth carefully weighing all the pros and cons when choosing the shape of the prosthesis. Drop-shaped are installed, according to strict indications. You should not take on unnecessary problems and make a choice in favor of such implants if the doctor, having studied your initial data, suggests installing round prostheses.

Re-correction

If, nevertheless, the patient is faced with the described problem, then do not despair. As we have already found out, the overturning of implants does not threaten health. Aesthetic correction in this case is not difficult. The surgeon will simply have to correct the already installed prosthesis. Of course, the operation will be performed under general anesthesia, the patient will have to go through a recovery period again, but all this will not take the form of a disaster. Rehabilitation will take a little less time and will be softer.

However, operational measures are resorted to only in isolated cases, when the shape of the breast has noticeably changed. Otherwise, the girls do not bother and leave everything as it is, because a slight asymmetry, as we have already noted, is quite natural and appropriate. In the end, I want to remind you that in any case, even if the new breast is in perfect order, you need to regularly visit your plastic surgeon as part of a routine examination. The doctor will notice any changes, if any, at an early stage and take steps to correct the problem.

Breast augmentation is one of the most popular plastic surgery procedures. In social networks and on forums, you can find a lot of horror stories about the complications and risks during this difficult procedure. The Aesthetic Medicine portal talked to a professional about this topic. Candidate of Medical Sciences and plastic surgeon Andrei Andrievsky spoke about the difficulties that women who decide to have breast augmentation may face. The doctor identified 5 main risks, 4 of which can be corrected by the same plastic surgeons.

1. Implant flip

Let's start with the flip of the implant. This happens when an anatomical implant is placed on a patient. Under certain circumstances, it can change its location and roll over. In this case, it is necessary to perform an operation to correct this complication: we change the “shifter” for another anatomical implant. By the way, if you replace it with a "round implant", then you can definitely not be afraid of repeated complications. Even if it rotates, it will not affect the appearance of the chest, - Andrei Andrievsky noted.

2. Capsular contracture

The second common complication is capsular contracture. All the implants we work with are ultra-modern and compatible with the body. That is, the human body does not reject them. But in any case, a certain capsule is formed around the implant. In rare cases, it becomes thicker than necessary, and presses on the mammary gland. Then you need to quickly remove the implant along with the capsule and put a new one, - says the expert.

3.4 Seroma and hematoma

The third risk is seroma. This is the fluid that sometimes accumulates around the implant. The problem is solved very simply: we remove all the liquid in one procedure using a miniature puncture. The procedure is carried out under the control of an ultrasound machine: we see everything we do, which means that we fully control the process. In addition, not only water can accumulate, but also blood. If it surrounds the implant, we do the same procedure: all excess blood is removed by puncture, the plastic surgeon reassures us.

5. Reduced nipple sensitivity

The fifth risk is a violation of the sensitivity of the nipple: complete or partial. Sensitivity usually recovers within a year. Sometimes for 2-3 years the sensitivity never returns to the end. In this case, we cannot do anything: it is impossible to restore sensations in this intimate place 100%.

Note that 4 out of 5 of these complications can be solved only with the help of professional doctors. And in the case of loss of sensitivity of the nipple, it is better to contact the doctors anyway. If you are about to go for breast augmentation surgery, it is best to be prepared for some of these risks in advance. Fortunately, all of them are not fatal with proper control and monitoring of the patient.