Breast Implants That Do Not Settle

I had breast implants revision 9 months ago. After having silcone implants for 20 years, I decided to go with saline. My surgeon suggested to put the implants under the muscle since the last ones I had were placed over the muschle. The problem is that since I had them done, they're no longer as big as the ones before (even though my surgeon says they're bigger) and they're not settling and their position is too high. I have done all the massaging and wore bands above the breasts but none has helped. Do I have to go back to this doctor and pay for him to fix this poor job? What else can I do?

Doctor Answers 30

Breast Implants Not Settling Caused by Submuscular Placement and Ptosis or Breast Sag

Thank you for your question. Breast Implants do settle and are often high for the first 6 weeks after breast Augmentation. This is especially true with submuscular implants.

Because your breasts have aged since your original implant, the breast has sagged down, a condition called Ptosis.

Placing the new implants under the muscle is an appropriate choice. However because the breasts have sagged, a breast lift will likely be necessary since the implants have not come down after 9 months.

Trying to release the implants to move them down risks a "double bubble" if the crease underneath the breast is violated. A lift is a better option

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At 9 Months, Revision is Advisable

Your photograph shows excessive upper pole fullness.

This can be corrected with a surgical release of the capsule to allow the implants to "settle."

Discuss with your surgeon.  Each practice has a different policy regarding costs for revision.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 14 reviews

Breast implant position

Your breast implants seem to be positioned too high. I don't believe that they are going to settle much without surgical intervention. Unfortunately, you will most likely need to have revision breast augmentation surgery.

S. Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 33 reviews

Please visit your surgeon

Either you have an early bilateral capsular contracture (unlikely) or your implants are too high or too high in profile. One of these is an explanation of why your result is currently not satisfactory. Start with your surgeon and see what they have to offer you. If you are not satisfied with the answer, go to other surgeons and get their opinions. Don't have any more surgery until you are confident with the doctor.

Revision breast surgery

In my opinion your breasts never settled into the pocket correctly (either they have developed too much scar tissue not allowing them to settle appropriately or the pocket was not made in the correct place).  It is difficult to access without an in office exam, but it looks to me that you need a simple surgery to release the scar tissue/capsule to allow the implants to settle more and not sit so high on your chest.  Every office has their own office policy on revision costs, so I would discuss this with your plastic surgeon.  Good luck!

Milind K. Ambe, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 15 reviews

Breast Implant Malposition

After 9 months, your implants should have dropped by now.  I don't think that additional massage, band wearing etc. is going to be of any benefit at this point.  It appears that you are going to need additional surgery to lower the pockets and therefore lower the implants.  As others have mentioned a capsular contracture on both sides could also cause this appearance, but that would be uncommon. 

If your original PS does not give you an answer that you are comfortable with, then you should consult with a few others (Board Certified PS).  Good Luck, Dr. Weider

Laurence Weider, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 69 reviews

Breast implants should look great immediately.


I am sorry to tell you that the notion that breast implants have to settle is a myth. Your breasts should look great right after surgery. You will need a revision in six months.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breasy Implant position issue

I am sorry to hear that you are having problems with your implants. You may have a capsular contracture, or the pocket was not opened up enough or the muscle adequately divided inferomedially. Needless to say, they should be corrected.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Should be settled by 9 months

The implants should be settles by 9 months.  This photograph shows preoperative bruising, so is much earlier after the surgery.  Your implants can definitely be lowered from this position without creating contour abnormalities.  Bands typically do not help, massage does.  If they are mobile and high, there is still hope that you can encourage them down.

High implants

You raise some very important points. First to replace your implants from the subglandular (beneath the breast) to the submuscular (beneath the muscle) pocket will take time to shape and drop, and you may require a breast lift. Your pictures reveal that the implants are high but you have wait the full time to heal to see where they finally end up. I don't believe you are looking at your final result. If the implants do not fall further and one year has passed then a breast lift (mastopexy) may be required. It is okay to stage this because you would have tried with less surgery.

Frank J. Ferraro, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 13 reviews

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.