I had a full Breast lift and Breast implant surgery 4 days ago. I requested to go to a full C or small D. My results have been great. My nipples are now where they should be, and I no longer have droopy breasts. My breasts however, do not look as large as I would have hoped. My PS put in 450cc's memory gel silicone under the muscle. I started off as a B cup. Will my breasts look larger as the implants drop, or should I have gone for a larger size?
Will Breasts Look Larger As Breast Implants Drop?
Doctor Answers (17)
Lift with Augmentation Will Take Time Before Achieving Final Appearance
As a general rule, implants will not look bigger after they "settle", BUT, there are several factors in considering how your final breast size will appear. First, the breast lift creates tension in the skin and breast that will eventually "settle" with time and that will be affected by the underlying implant. Second, the implant will "settle", both with respect to the overlying lifted skin and breast envelope, but also due to the accommodation of the overlying muscle. Since this is not a saline implant, you won't have the usual "relaxation" of the saline implant that occurs with time, so the size of silicone implant, as it appeared when place on the operating room table, will not change. Finally, you have the natural occurrence of the body's response to trauma (surgery), so there will be swelling of all the tissues affected (skin, fat, breast, and muscle), and then there will be some element of retraction of this swelling....some skin types don't retract back as well as others. All of these factors effect the final breast appearance (size, shape, symmetry), and as surgeons, we hope that our expertise allows us to accommodate for all of these factors during the surgery so the final appearance on the OR table is a prediction of what to expect after several months of healing. Remember, the acute healing phase takes about 6 to 8 weeks, before transitioning into a chronic healing phase. So time and patience are important to achieve the final result we had planned to achieve. Of note, many times patients in the very early time frame (first week), get used to the appearance of the large, swollen breast, and then when it "settles" they think they are "small"....this is when reviewing your pre-op photos are helpful, because you can clearly see that, indeed, you are "bigger" but hopefully well proportioned. A 450 cc gel implant is fairly large, depending on your height/weight/stature. So presumably you will be happy with your outcome with that large of an implant once the healing process is complete. Remember, breasts look differently in a frontal view than they do from the side view....if you are "rounding" from the side, you are probably "big enough" and didn't need to go with a larger size. And be sure to follow you surgeon's post-op recommendations to prevent problems as you heal!
Dropping of Breast Implants
You are very early out of surgery so I would recommend that you do not worry about the size just yet. The breast shape and size does change as the implant drops into the pocket. Many patients have told me that it does look bigger after things have settled. Enjoy your results and allow yourself time to heal before making the decision that you are too small. You can discuss that with your surgeon after 6 months or so when everything is settled.
Will Breasts Look Larger As Breast Implants Drop?
After a breast lift and breast augmentation, it will take time for the breast implants to settle and the skin and the breasts themselves will undergo some changes. It is best to wait for at least 6 months then you will have a better idea about the final shape and size and appearance.
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Breast implants feel smaller as they drop
First let me address what this "dropping" is all about. When an augmentation is done with a very full implant, or the breast initially is small and tight, or when the fold under the breast is firm and tight, the breast and implant need a settling in period to accommodate one another. It can take several weeks after an augmentation procedure for the implant and breast to work in together and produce a 'marriage' between the two. The more we are asking of the natural breast, the longer the time it can take for the implant to settle in and feel soft and natural. The dropping of the implant is actually a relaxation of the skin and fold under the breast producing a natural shape as the implant and breast now fit one another. Not all implants must "drop" as the skin envelope may fit well at the start, however again as we ask more of the breast, say an A to a D the end result will take some time.
When an implant does not fit the breast we often refer to them as being high, as they push up into the upper portion of the breast. At this time the implants will appear larger and have a greater projection than is normal. We also see this occur with capsular contracture as the implant will round up and move slightly higher filling out the upper portion of the breast more than the lower and make that breast look bigger.
Your surgeon was probably correct with the choice of implant made and bigger is not always better. As we push the breast envelope too far with a very large implant we also can see the dreaded "double bubble" where the implant pushes below the natural fold of the breast with a distorted pear shape. Better to go larger at a later date.
Best of luck,
Breast Implants Will Drop Into Normal Position Giving a Natural Appearance
Immediately after breast augmentation the breasts are often quite snug. As time goes on, the overlying breast and muscle tissue should stretch. Usually the tightest part of the postoperative breast is the lower portion. As this part of the breast relaxes, the implants will settle more into the lower part of the breast, giving a more natural appearance. Often, the stretching will allow for more projection to develop. Projection is the dimension between the chest wall and the most projecting part of the breast which is normally the nipple area. As the volume of the breast shifts more to the lower part of the breast and as the central part of the breast stretches, you may look larger in your clothing. Typically, this shift of volume takes some of the volume away in the upper part of your breast. Most women however, equate larger breasts with increased projection in the central part of the breast.
Do breasts look larger as implants drop?
Early on, swelling obscures the shape of the breasts and the definition of the borders around the implant. Therefore, the cleavage is less and the implants look flat and wide. With time, they get better shape and definition, but do drop some. As they drop, the swelling and upper-pole fullness goes away which causes some patients to think that they actually look SMALLER as they drop.
Breast Implants Following Surgery
It’s not uncommon for patients to express concern about breast size in the immediate post-operative period. Multiple factors make it impossible to assess breast size four days after surgery. This is even more so when breast lift and augmentation are performed in combination.
Several factors affect the size of breasts in the immediate post-operative period. These include swelling of the breast tissue, swelling of the surrounding tissue, settling of the breast implants and muscle spasm. For several months following surgery each of these phenomena is undergoing significant change. These factors interact in a complex manner to create a rapidly evolving situation. It’s virtually impossible to make decisions about breast size until the situation has stabilized.
In some cases, it may not have been possible to place a larger implant at the time of the original procedure. During surgical procedures it’s not uncommon for surgeons to make compromises to obtain the best possible aesthetic result. In some cases, utilizing larger breast implants may cause conflicts with other aesthetic goals. For instance having larger breast might create and unnatural look which may not be desired by the patient. It may disrupt harmony, balance, and proportion with other surrounding structures.
It might also affect patient safety. When breast lift and augmentation are performed together, a larger breast implant might compromise blood supply to the nipple areola complex. All of these concerns might place limits on implant size with this procedure.
In most cases, resolution of post-operative swelling results in a decrease in apparent breast size. Occasionally resolution of swelling in the surrounding tissues results in greater definition of the breast and the perception that they’ve increased in size. The vast majority of patients are happy with their breast size after a brief period of adjustment. Rarely secondary procedures are necessary for size.
I am sorry but they won't enlarge after the swelling goes down.
In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements
Choosing Size for Breast Lift and Augmentation
The brief answer to your question is that it is unlikely that your breasts will look larger in time. It is true that it will take about 6 months until your breasts have reached the final shape and appearance. However, this will most likely be more of a settling and change in shape, rather than any change in the size. Unfortunately, it is likely that the size will decrease slightly over the next month as you are only 4 days following surgery and at this point there is also still some swelling.
With a combination of breast lift and augmentation your plastic surgeon needed to be extremely careful as being too aggressive and putting in a large implant can compromise the results and cause serious complications. The 450 mL implant that you describe are a reasonable size, and going larger could have resulted in excessive stretching of the skin and opening of the wounds. this required very careful consideration, and the expertise of your plastic surgeon is invaluable in this regard.
To help with size selection following breast surgery I am fortunate to have access to 3D Vectra technology in my practice, and I find this beneficial to help patients visualize their result and choose appropriate size implants.
Web reference: http://www.corygoldbergmd.com/vectra-3d.html
Too early to judge the final results
Your breasts will not appear larger as the implants settle into position but the shape will improve. You are still early in the post operative recovery period so it is time to give it a chance before you judge the final result. A 450 cc implant should have increased your breast sized by 2 cup sizes.
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.
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