Why Do Breast Implants Flip? AP Malposition Explained

If your breast suddenly changes shape, you might think your implant has ruptured — but it may have actually flipped. We call this AP malposition (anterior-posterior malposition), where the round front side of the implant rotates to the back, and the flat backside ends up in front.

This happens when the capsule — the scar tissue sac your body forms around the implant — becomes too large and allows the implant to spin too easily.

In a perfect world, you have a Goldilocks capsule: just big enough to hold the implant, not so tight that it causes a weird shape, but snug enough to keep the implant in place. If the capsule stretches over time and becomes weak, it gets bigger — and the implant is more likely to flip.

These implants are more ball-like. They're not as flat, so they spin more easily inside an enlarged capsule.

The repeated pressure of the pectoralis muscle on the implant stretches the lower capsule and enlarges it over time. I see flipped implants more often in my submuscular patients.

Big, heavy implants stretch the capsule more, making it too large relative to the implant — which allows it to flip.

If your implant has flipped and it's the first time, we can often flip it back manually — and it will usually stay in place.

But if you've developed a capsule that's much larger than the implant, especially with high-profile implants, it might start repeatedly flipping. Some patients even experience pain when the implant is upside down.

If that's the situation, unfortunately the only fix is revision surgery to address the capsule and stabilize the implant.

A flipped implant isn't a rupture — it's a capsule problem. It's more common with high-profile implants, submuscular placement, and larger implants. If it keeps happening, surgery is the only reliable solution.