Breast implant positioning issues, or implant malposition, occurs when the breast implants are not in the correct position within the breasts and cause an unnatural look and/or feel. Positioning issues can manifest over time as a result of a complication, or they can develop quickly as a result of injury or trauma.

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Characteristics of Implant Malposition

  • Pain or discomfort
  • Unnatural breast appearance
  • A change in the way the implants feel
  • A visible change in breast shape

Causes of Implant Malposition

There are four main causes of breast implant malposition:

  • Capsular contracture: The scar tissue that is expected to develop around the implant tightens and squeezes the implant out of place.
  • Trauma: A major injury such as a car accident can damage the pocket and/or cause the implant to move.
  • Surgical error: The surgeon created the breast implant pocket incorrectly.
  • Poor choice in implant size: Positioning issues can occur when the patient chooses implants that are too large for her natural anatomy to support.

Types of Malposition

High Malposition

High implant malposition is the most common type of malposition. It occurs when the breasts appear too high on the chest. Many times, the breasts will naturally appear this way soon after surgery but will “settle” into their correct position within a few days. If they are still high once healing should be complete, revision surgery may be needed. High malposition can also occur when the patient wears an underwire bra during recovery since it can put pressure on the breast pockets and prevent the implants from settling.

Lateral Malposition

Lateral malposition occurs when the implants shift to the sides of the body, creating a large gap between the breasts. This can be caused by a poorly created implant pocket or by weak breast tissue that cannot support the implant.

Low Malposition

Low implant malposition, also called “bottoming out,” is more likely to occur with larger breast implants. The breast pocket may have been created too low on the chest, or the implant could simply fall too low despite a correctly placed pocket.


Symmastia, although very rare, can occur as both the implants merge together in the center of the chest, sometimes forming a “unibreast.” Larger and/or high profile implants are contributing factors to this complication, especially in patients who are thin. Symmastia is most often caused when the pockets are not positioned correctly or when they are made too large.

Correcting Breast Implant Malposition With Breast Revision Surgery

Breast revision surgery for implant malposition will be different for each patient. In general, the breast pocket is evaluated and reconstructed to hold new implants. The pectoral muscle below the implant may need to be released so the breasts can lie in their natural-looking position.

If you are interested in breast revision surgery with Dr. Allen M. Doezie, please schedule a consultation by calling 949.481.9850 or by filling out our online contact form.