Breast Settling After Breast Augmentation

I had breast augmentation done 4 months ago. In addition to my right breast now sitting approximately a half inch higher than my left breast, and both have a significant amount of loose skin under the breast.

My Doctor has me wrapping my breasts in a bandage for 6 weeks to try to work them down into the breast pocket. Is this going to give me the desired effect, or will I eventually need to have them redone?

Doctor Answers 22

You won't really know until after 6 months...

Being that you are already four months postop your implants would have settled by now. It seems that your implants are high and your surgeon is trying to move them down using wraps. You breast implant pocket capsule is getting quite mature and will probably not move much. I have seen and dealt with this problem many times. I would wait until the six months are over and then fully evaluate your clinical situation with your surgeon. At six months, you will have one of the following scenarios to deal with:

  1. Your implants are equal in position and you are happy
  2. Your implants are unequal in position but the breast tissue sits squarely on top of each implant (no sag)
  3. Your implants are unequal in position and you still have sagging breast tissue that is below the center of the implant
  4. Your implants are equal in position and look good on your chest, but your breast tissue sags below each implant.

If you experience situation #1 - Congratulations!!!

If you experience situation #2 - You will need to discuss with your surgeon the need for a pocket adjustment procedure to get them closer to the same position. If one implant is perfect and the other is too low, then the low one needs to be raised. If one implant is perfect and the other is too high, then the inframammary fold needs to be lowered to bring the high implant down to match the good one.

If you experience situation #3 - you will need the same procedure described in situation #2, with the addition of a breast lift to get the breast mounds to rise back up squarely on top of the implant.

If you experience situation #4 - you will need a breast lift only to put the breast tissue back squarely on top of the implant.

Good luck :) Dr. Shah

Breast Implants Settling

It is common for implants to take some time to settle into position, and it's common for the process to be asymmetric.

At 4 months post-op, you might still see some improvement.

Continue to work with your surgeon and ask him his expectation and time course, before he would recommend revision.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 17 reviews

Revision is certainly a possibilty

Given what you have described, I would not be surprised if you need a revision in the future. It sounds like you may have had some extra skin or breast ptosis before your procedure, which can often be addressed by performing a breast lift at the time of the augmentation. If this was the case, it may be difficult to now manipulate the implant to make it drop into the proper position, in particular if the implant was placed behind the muscle.

My advice would be to wait a minimum of 6 months after your surgery to consider any revision. Discuss with your doctor your concerns and he will likely give you one or more options for surgical revision.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 119 reviews

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If you do not see the results you desire in the next few months, you will likely need a revision.

Lmorton,

I have found that it usually takes about six months for the breast implants to properly settle. However, what you describe presents two issues. First, if one implant is higher than the other, you may require a revision surgery to fix that asymmetry. While wearing straps may help, at this point, I would not expect much difference. Second, the "loose" skin under the breasts, may indicate that you also need a mastopexy or breast lift. While the implants may settle somewhat, if there is breast tissue hanging off of the implants, this is unlikely to resolve without further surgery.

David Shafer, MD
Shafer Plastic Surgery
Manhattan

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 64 reviews

Time for final breast augmentation shape to occurr

Hello,

It is hard to know without photos but it sounds like you may need a revision.  The revision may consist of

1) lowering the pocket

2) changing the implant size or diameter

3) getting a lift

All three of these may be solutions to potential issues you are describing.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 124 reviews

Uneven settling of breasts.

It is quite common for breasts to settle unevenly and have one descend faster than the other. Different types of exercises may be used for thise purpose as well as the use fof specialized bands.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 56 reviews

Implant settling after breast augmenation

Typically it takes breast implants 3-6 months to settle completely after a breast augmentation.  Breast straps (bandeau) which place downward pressure on the implants, aggressive massage, and patient observation are effective in treating most cases of early asymmetry.  If there is still considerable asymmetry after six months, a revision may become necessary. 

Kelly Gallego, MD, FACS
Yuba City Plastic Surgeon
5.0 out of 5 stars 39 reviews

Breast Asymmetry after Breast Augmentation

Breast Augmentation results will often continue to settle up to about 6 months.  Asymmetries with regards to superior fullness and breast folds can commonly be manipulated with massage and bandeaus that force the breast implants into a desired position.  In very muscular patients, a muscle relaxant can help facilitate correct positioning of the implants in the created pocket.  Common causes of breast implant asymmetry are pockets that are not of similar dimensions, an early capsular contracture, and an inframammary fold that has fallen from its desired position.  At this point I would discuss your concerns with your Plastic Surgeon, but give it another few months to make a decision.  If you do not like what they have to say, I would seek another opinion.  Good Luck.

Settling occurs for 3-6 months, be patient.

The period of time following breast augmentation surgery is characterized by significant change.At this time, swelling, muscle spasm and the wound healing process can all alter the appearance of the breast.
In some cases, superior implant displacement may be due to swelling and muscle spasm when implants have been placed beneath the muscle.In other cases, superior implant malposition may be related to inadequate dissection of the muscle insertions of the inferior portion of the breast pocket.
With time, assuming adequate pocket dissection, these implants will often drop into their normal position.This process usually takes about 3 to 6 months.If no progress has occurred by then, revisional surgery may be necessary.This would involve recreating the lower portions of the breast pocket.
Your history suggests that progress has been slow and that your breast implants are still relatively high.For these reasons, consultation with your plastic surgeon is appropriate.Under these circumstances, revisional surgery may be a distinct option for you.

Breast Settling After Breast Augmentation

 Thank you for the question; congratulations on having undergone the breast augmentation procedure.  Generally speaking, when breast augmentation is performed a “pocket” is created.  Depending on the size  and position of the breast implant pockets  dissected,  as well as the size of the breast implant used,  it may take some time for the breast implants to “settle” into the dissected pocket.  This process may be referred to as “dropping and fluffing”.  It may  require 3 to 6 months to occur.  at this point, although easier said than done, I would suggest ongoing patience;  you will find that time and patience will be your "best friends" over the next several weeks/months. Best wishes.

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.