320cc Subglandular Silicone, 3 Wks Post-op. I Know They'll Drop, but Will They "Fluff" Too? (photo)

Hi there, I was curious about this "dropping and fluffing" phenomenon. Do implants over the muscle (particularly subglandular like mine) fluff like unders do? I'd love for that to happen since I am one of the many that kind of enjoyed the size I had with swelling. Thanks in advance for your help!

Doctor Answers (6)

You can be sure your implants will drop over time as you heal. But "fluff?"


Gravity "works" 24/7, and tissues always stretch with time and the relentless pull of gravity, especially when there's more weight (implants) to "pull." At 3 weeks post-op your scars are still very immature, and can be expected to soften, stretch, and mature over an average of 7 months. Maybe more, and maybe less, but still over many months, not weeks!

Since your incisions are still pink and a bit firm, and your scars are still maturing, you can reasonably expect that your internal capsule scars are healing/maturing at much the same rate. Once your skin incisions are completely pale, flat, and soft, then your capsule is likely completely healed as well, and after that, implant position is subject only to aging and gravity over the longer time span--the former takes months to occur, the latter years.

So the ultimate answer is that it depends on your present appearance, your goal appearance, and what you look like at 6-12 months post-op. Talk with your surgeon. If you are still noticeably high after healing has completed and all scar tissues matured (6-12 months) and you really want to drop your implant positions a bit, a simple operation to open up the lower pockets a tiny bit is possible!

But if you take "fluffing" to mean that your implants will somehow "expand" or look larger as time goes by, this depends on the degree of skin and muscle stretch that allows the "high, tight" look to become more teardrop and "natural." But any degree of "looking bigger" is often offset by true volume reduction as swelling decreases. Everyone is different!

BTW, "fluff" is not a medical term, and usually relates to what certain adult film "assistants" do in order to keep the male actors "ready for filming." Ahem. So let's just say drop and soften, shall we? Best wishes! Dr. Tholen

Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 reviews

"Drop and fluff"


Dropping:  Submuscular implants are sitting as if they are at the bottom of an envelope. The breast fold, like the bottom of the envelope keep the implants from descending. At the upper pole is a large space under the muscle and above the ribs, and that space goes up to the clavicle (collar bone). Typically the implant position looks fine at surgery. As the patient awakens, the relaxed pectoralis muscle contracts, pushing on the implant. This displaces the silicone (or saline) which bulges into the upper pole, the only direction with room to expand. The lower pole of the breast may seem to empty out. But the implant itself doesn't actually move. As the muscle relaxes over several months, the upper pole no longer bulges and the implant position looks like it did in surgery.


This is not a phenomenon that is seem with implants placed above the muscle. There can be some lowering of the implants as the lower pole skin stretches in response to the weight of the larger breasts. 

I am not familiar with the term fluff. I looked for a useful definition on various websites, but the definitions are all over the place, and not helpful, so I will pass on that half of your question. 
All the best.  

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 31 reviews

Fluffing Will Also Occur

"Drop and fluff" refers to the gradual movement and change in shape that occurs to breast implants. When breast implants are first put into your body, they typically sit higher up in the chest. This is because it’s the path of least resistance – your body requires some time to adjust to their presence, regardless of whether they’ve been placed in a sub-mammary (between breast tissue and chest muscle) or sub-muscular (under both the breast and chest muscle). Immediately following surgery, you’ll find that your newly enhanced breasts appear very full and swollen, especially in the upper portion above the nipples. Your skin will most likely look very tight and your nipples may point slightly downward as well. This may make the shape and overall appearance of your breasts appear unnatural. Don’t worry, because they will change for the better, something casually known as “dropping and fluffing”. As your body accommodates to your new implants, you’ll notice that your breasts will gradually look more and more natural – the way you hoped they’d be! Over the course of about three to four months, your body creates new skin to accommodate the additional volume of your implants. This natural process is called “tissue expansion”, and relieves the tightness you may be experiencing. It allows for the implants to settle more into a better position with the help of gravity. A gradual redistribution of volume from the upper to the lower breast occurs, resulting in an enlargement and rounding out of the lower breast.

Although it's often called "dropping", it is more like "redistribution". The "fluffing" part refers to the impression that the lower breast enlarges and that your skin softens with the creation of new tissues. The extent to which this occurs depends on several factors, including the implant size, the tightness of your skin, and your body shape.

Patients who experience this phenomenon at a higher rate typically:have a smaller body frame
are tighter skinned
haven’t had children

This is in comparison to a larger breasted, post-partum woman. Patients who have had implants placed sub-muscularly may find that their dropping and fluffing is more dramatic. For the few months this occurs, you may want to hold off on buying new bras. Because your breast shape will most likely change, you might buy a bra that hasn’t been fitted properly.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 57 reviews

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Those are not great terms to use, implants under the muscle will come down in a few months and implants under the breast tend to stay still. Both will have swelling that will come down

Ryan Neinstein, MD, FRCSC
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Implant position


Submuscular implants tend to sit higher initially because of muscle spasm than those in a subglandular pocket. 

Steven Wallach, MD
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Fluffing and Dropping after Breast Augmentation


    Subglandular implants may drop after 3 weeks.  However, submuscular implants tend to do more dropping than subglandular.  I am uncertain of the reference to fluffing. 

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.