Hello, I am 27 years old - 5' 3" 155 lbs. Medium frame. I recently had a bilateral mastectomy and went thru the tissue expansion process and had the expanders filled to 600 cc's before implant surgery. I am one week post surgery and my silicone gel implants are 650 cc's. My question is how long does it take for the implants to settle or take the shape/look that they will ultimately be. I came out of surgery expecting bigger (at least a full C cup)- and what can I do to help recovery.
How Long Does It Take Implants to Look "Normal" After Reconstruction Surgery?
Doctor Answers (7)
Depends on the devices and the amount of swelling!
It can take a few months to see final results.
Be Patient with Breast Reconstruction Results
The size of the final implant is determined by the amount of volume placed in the implant during the expansion procedure. Tissue expanders project more than silicone gel implants, and that is why your surgeon was able to place 650 cc implants after using 600 cc expanders. Also, the width of your chest wall limits the size of the implant, as one must be careful to not place too wide an implant in the pocket that it extends into your axilla, or underarm.
It takes about 3 to 6 months before most women see the final size and appearance of their reconstructed breasts, so be patient. It is wise to wear a good, supportive bra, especially when exercising, to help keep the implants in a good position. Also, massage the breast to keep it soft and pliable. Taking an antihistamine, such as an over-the-counter anti-allergy medicine, may help decrease your risk of capsular contracture. I also recommend avoiding isolated pectoralis muscle strengthening exercises, which can result in visible contracture of the muscle with activity if you are very thin. Plank exercises associated with yoga and push-ups are OK.
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Recovery after Silicone Implant Reconstruction of the Breast
It can take several weeks to months for an implant expander breast reconstruction to settle down and depending upon the quality of the skin envelope may vary considerably. Later scar capsule contractures can form around the breast implant causing them to be deformed or displaced.
For these reasons, when appropriate, I prefer to used autologous tissue techniques for breast reconstruction where a soft, warm natural breast con be made using your own fat and skin tissues. These breast reconstruction flaps include a TRAM flap, and DIEP flap to name two.
See nybreastreconstruction.com for more information on breast reconstruction options.
Recovery After Breast Reduction
With a breast reconstruction like yours, it may take anywhere between one and three months for the implants to settle or take the shape/look that they will always have. After tissue expanders are exchanged for implants, the soft tissues covering the implants will conform to the new implant shape rather than the previous expander shape. Sometimes there may be little change after surgery, but more often this process takes several weeks to be completed. If you were expanded to 600cc and 650cc implants were placed, the implant pocket is probably fairly tight around the implant and there may not be much change over time. With 650cc, you should actually have a C cup volume, but because the implants are not the natural breast shape, they may not completely fill out a bra cup. To help the implants settle and to help keep the breasts as soft and natural looking as possible, some surgeons recommend some form of implant massage. You should check with your doctor to see if this is recommended in your case and follow whatever he/she recommends.
At one week post implant placement, you are very early and there is probably a lot of swelling. You need to give it six months or longer.
Normal after Implant Recnstruction
Depending on the type of mastectomy you had, the skin envelope will play a large role in the final shape. Skin and Nipple sparing mastectomies allow for a much more aesthetically pleasing result than traditional mastectomy. It is also important to view breast reconstruction as a process and not a procedure. It is not uncommon to require revision down the road to obtain the optimal shape and size. I typically wait 6 months to determine the final position of the implant, prior to discussing any revision. IAll the best in a safe and happy recovery.
Paul S. GIll, M.D.
Gill Plastic Surgery
Houston Double Board Certified Plastic Surgeon
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.