Another breast augmentation complication that occurs after breast enhancement plastic surgery is breast implant malrotation. This is often undiagnosed except be a keen eyed person. It can only occur after using 'tear dropped' shaped breast implants. These tear dropped shaped breast implants have a definite axis or orientation. The upper half of the implant is narrower and less projecting, and the lower half of the breast implant is wider and more projecting. These breast implants must be positioned in the woman very precisely and with essentially no margin for error. These breast implants are designed not to move and have a textured shell. The plastic surgeon will usually try to create a small pocket that is only large enough for the breast implant.

This smaller breast pocket is designed so that the breast implant will not move or rotate. Unfortunately over time, a tear dropped shaped breast implant will usually rotate. Then the woman is left with a distorted shaped breast mound. If this distortion is not identified, then the woman's breast skin will stretch and this will exacerbate the irregular shape of the breast and make the plastic surgery to correct the rotation more difficult. Usually this is the case when a woman comes in for questions about her 'strange' breast shape. When a second breast implant plastic surgery is performed, the shaped breast implant is removed, and a round smooth breast implant is placed to try to correct the deformity. Because the breast skin has been stretched disproportionately, the nipple will usually be in a different position than the other breast's nipple position. These nipple and shape asymmetries can be worse if both shaped implants have rotated in different directions or to different degrees of rotation.