Causes of implant displacement: definition, types and risk factors
Implant displacement occurs when a breast implant moves out of its intended position – for example, due to an implant pocket that is too wide or weak connective tissue.
Causes of implant displacement
Implant displacement occurs when a breast implant moves away from its originally intended position within the tissue. The most common causes are an implant pocket that is too wide, insufficient connective tissue and mechanical strain during the healing phase.
Table of Contents
Important note
This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.
Causes of implant displacement explained: Background and details
One Implant displacement occurs when a breast implant moves out of the position within the tissue intended by the surgeon following a surgical procedure. The implant is not firmly anchored, but lies within a so-called implant pocket – a specially created pocket of tissue that determines the implant’s position and stability. As soon as this pocket becomes too large or the surrounding tissue provides insufficient support, the implant may slip out of place.
Medically, a distinction is made between three main forms: In the case of Bottoming out the implant slips downwards, in the case of the Rotation it rotates inside the bag, and when the lateral dislocation it moves sideways. Each type has characteristic external features, ranging from an asymmetrical breast shape to a feeling of tightness.
Implant displacement is not a medical emergency, but it does require assessment by a specialist. If left untreated, aesthetic changes may become permanent or worsen. Important to note: Not every change in appearance following breast augmentation automatically indicates that an implant has slipped. Swelling in the first few weeks after the procedure is normal and is not a reliable sign of an implant having slipped.
Key points at a glance
- The implant moves out of the tissue pocket originally created
- Three forms: bottoming out, rotation, lateral dislocation
- The causes lie in the technique, the tissue, the size or post-operative behaviour
- Not an emergency, but a consultation with a specialist is required
How does implant displacement occur?
The causes of implant displacement can be divided into three categories: surgical and technical factors, patient-related factors and implant-related factors. The following table provides a structured overview:
| Category | Cause | Explanation |
|---|---|---|
| Surgical | Implant pocket too large | If the pocket is made larger than the implant, the implant will have too much room to move. |
| Surgical | Incorrect implant size | Implants that do not match a person’s individual body proportions place greater strain on the tissue. |
| Patient-related | Weak connective tissue | This occurs particularly frequently in cases of ‘bottoming out’; the tissue gives way under the weight of the implant. |
| Patient-related | Physical exertion too early | Exercise or heavy lifting during the recovery period significantly increases the risk of displacement. |
| Patient-related | Smoking / Diabetes | Both factors slow down wound healing and weaken tissue stability. |
| Implant-related | Implant shape (teardrop-shaped) | Anatomical implants show rotation more clearly from an aesthetic point of view than round implants. |
| Implant-related | Smooth surface | Smooth implants adhere less to the tissue than textured ones, which promotes rotation. |
The process of displacement is often gradual. In the first few weeks after the operation, the implant pocket is still soft and malleable. If the tissue is subjected to excessive mechanical stress during this phase, or if the pocket is too wide from the outset, the implant begins to shift position gradually, though this is often only noticeable after several months.
Practical examples
Experience shows that ‘bottoming out’ occurs more frequently in patients who have opted for very large implants (from a volume of approximately 400 ml) and who also have a naturally thin skin and connective tissue structure. In such cases, the tissue yields to the sustained weight of the implant over a period of months; the inframammary fold shifts measurably downwards, and the distance between the nipple and the inframammary fold increases.
In the case of the rotation problem, clinical experience shows a clear correlation with pocket geometry: if an anatomical (teardrop-shaped) implant is inserted into a pocket that is too wide, even a rotation of 90 degrees can cause the breast to appear distorted from the side. With a 180-degree rotation, the breast appears to be upside down. Round implants, on the other hand, do not exhibit this aesthetic change when rotated, as their shape remains identical in any orientation.
According to information from plastic surgery practices, clinically significant implant displacement following breast augmentation is most commonly observed within a period of up to 36 months after the procedure; for this reason, follow-up cost insurance with a 3-year term is recommended for breast implants.
Common mistakes and best practices
Common mistakes that increase the risk of implant displacement:
- Physical activity at too early an age Many female patients underestimate the importance of the recovery period. Sport and heavy lifting should be avoided for at least 6 weeks after the procedure.
- Poor sleeping habits Sleeping on your side or stomach during the first few weeks may affect the position of the implant.
- Missed follow-up appointments Anyone who misses their check-ups will only notice the onset of a change once it has already progressed.
- Implant size not in proportion to body size Implants that are significantly too large for the existing breast tissue significantly increase the risk of bottoming out.
- No bra support during the healing phase Medical support bras stabilise the implant during the healing phase and reduce the risk of displacement.
Note on financial security
Despite careful planning and proper aftercare, implant displacement cannot be completely ruled out. Corrections are medically necessary procedures which are not usually covered by statutory health insurance. A Consequential Costs Insurance covers precisely these kinds of complications, including implant displacement and the resulting asymmetries.
Frequently asked questions about the causes of implant displacement
Breast implants are placed within a tissue pocket and are not firmly anchored. Consequently, an implant can, in principle, shift out of position, particularly if the implant pocket has been created too large, the connective tissue is weak, or the implant is subjected to mechanical stress too early during the healing phase. The risk is highest in the first 12–36 months following the procedure.
Typical signs include visible asymmetry of the breast, a change in the position of the nipples, an unnatural-looking shape or a feeling of tightness in the breast area. If teardrop-shaped implants rotate, the breast may appear distorted at the sides or look „upside down“. Any noticeable change in shape should be investigated by a specialist.
Statutory health insurance funds only cover the costs of breast implant revisions in very limited exceptional cases, such as where there is evidence of damage to health. Revisions carried out for aesthetic reasons are generally not reimbursed. Privately funded revision surgery can cost several thousand euros. A Consequential Costs Insurance steps in here and covers the costs of medically necessary follow-up treatment and corrective procedures.
Implant displacement can occur both shortly after the procedure (within the first few weeks) and months or years later. In the case of capsular contracture, a common associated complication, displacement or deformation typically develops within 1–3 years of the procedure. Experts therefore recommend that insurance cover for breast implants should be for a minimum of 3 years.
No. Once breast implants have shifted, they do not return to their original position on their own. Correction requires a further surgical procedure, during which the implant pocket is adjusted and the implant is repositioned or replaced. Conservative measures such as massage or special bras can slow down the progression, but cannot rectify an existing displacement.
The three clinical forms of implant displacement: bottoming out, rotation and lateral dislocation, along with their respective main causes.