Do You Think the Swelling in Cleavage Area Under Left Breast Will Go Down? (photo)

I am currently 3 weeks post op. I received 450cc silicone under the muscle in both breasts. My left had to have a bolster put in to prevent bottoming out due to asymmetry pre-op. Ever since I had the bolster removed(at 2 weeks post-op) I have had swelling in the cleavage area around my left breast. It's slightly odd shaped in that same area as well. I would like to add that is NOT a revision, it's my 1st surgery and from what I've read bolster's are usually used in revision surgeries.

Doctor Answers (11)

Early symmastia and asymmetry after breast augmentation.

+2

You appear to have had slightly differing degrees of medial dissection in the creation of your submuscular pockets. This is causing the cleavage issue that appears to be early/mild and asymmetric symmastia (uniboob). Pressure towards the cleavage area via your surgical (or regular) bra seems to be aggravating the issue, and can cause worsening of the symmastia over time, as well as tending to "close down" the lateral pockets. (I know you were probably told to wear a bra to help avoid bottoming out, but the bra is causing a different concern that you are now asking about.)

Other than waiting to see how all this heals, settles, and softens (D & F is not appropriate plastic surgical terminology), you can discuss this all you want with your surgeon, but it won't even have a chance to get better unless you do the following immediately:

Stop wearing any kind of bra that compresses the breasts towards the cleavage area--this pretty much is all "normal" bras, but especially stretch or jog bras, and especially "push-up" bras. These bras push the implants towards the cleavage area, further stretching the already thinned and partially detached tissues that are secured to your sternum (breastbone). They also tend to close-off the lateral pockets so that the implants are no longer centered under the nipple/areola complexes. For your frame and with this implant size and profile, you should have a bit more "side boob" and less pressure on your cleavage attachments.

Your surgeon may indeed want you to support your implants to avoid them dropping excessively (bottoming out), since they don't look overly high at 3 weeks post-op, and the use of a bolster was described as being done to "prevent bottoming out," but this has to be done without pressure from the sides towards the center.

The only device that both supports the breasts and outwardly displaces implants (relieving pressure centrally and minimizing symmastia) is a symmastia bra, often called a thong bra. Your surgeon should know about this; ask him/her about this immediately. They are available online if your surgeon's office doesn not stock them.

I would recommend wearing the symmastia bra day and night for a minimum of 6 weeks, to allow the central tissues to heal and toughen up (if possible, and if they are not already too stretched or detached), while also stretching the lateral pockets for better implant position. The symmastia bra straps can be adjusted to provide lower breast implant support so you do not bottom out excessively.

Other than this, revisionary surgery may well be necessary, but should not be undertaken for at least 3 months (6 months would be better).

I have never used a bolster in primary breast augmentation (1st time patients), so you have to ask your surgeon about that. I presume it was for a good surgical reason and based on your surgeon's best judgement at the time of surgery, and hard to comment on pre-op asymmetry without photos or personal examination.

3 weeks is still quite early in the healing period, so please aks your surgeon about a symmastia bra and stop wearing a regular bra. You may have been told to wear this to prevent/minimize bottoming out, but I suspect you are causing a "new" problem in the symmastia you are developing. Best wishes! Dr. Tholen


Minneapolis Plastic Surgeon
5.0 out of 5 stars 144 reviews

Cleavage Swelling 3 weeks After Breast Augmentation Will Go Down

+1

Thank you for your question. Your result looks very good for 3 weeks. Your implants will drop and move down and not encroach on the cleavage as they now do. You also have significant tissue swelling which will resolve.

I predict this will not be a problem after 6-8 weeks.

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Swelling 3 weeks after breast augmentation

+1

It is very normal to have swelling 3 weeks post breast augmentation.  I would expect this to resolve with time.  Good luck.

Sacha Obaid, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 25 reviews

You might also like...

Will swelling in my cleavage area go down?

+1

At 3 weeks post-op, it is too soon to worry because you still have to heal.  Everyone is different so you may still have some swelling left to go down.  But from your photos, my concern is that you are close to experiencing a symmastia (uniboob).  I would talk to your surgeon about your concerns and discuss precautions and options for revision if necessary but you need to give yourself a few months so you can heal and see what your final results will be.  

Angela Champion, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 4 reviews

Do You Think the Swelling in Cleavage Area Under Left Breast Will Go Down?

+1

WOW! Your result is very good. I would allow at least a few months before considering anything be done or even thought about. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Early problems with symmetry after a breast augmentation

+1

At three weeks you are still early in the post operative period.  There are several features that are visible now that may improve with time.  The left medial pocket appears to over dissected superiorly and under dissected in the medial inferior area.  I would allow things to settle down over then next few months.  During your post operative visits discuss your concerns with your surgeon.  If appropriate a revision may be needed.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 10 reviews

Wait to see after breast augmentation

+1

You are right in that the skin envelope wll relax and the implant and breast tissue come together. I don't know about the bolster thing, however now use a good underwire to support, and wait to see how you look.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 31 reviews

Enlarging the base of the implant pocket after breast augmentation can help.

+1

Hi.

I would do nothing for four months.  At that time, you may decide that your result is good enough. Otherwise you may need a touch up.  I doubt that left breast will come down on its own, but it may!

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

Swelling after #BreastAugmentation

+1

IT appears that the cleavage is somewhat asymmetric, but this could be related to the position of the muscle beneath the skin or the dissection of the pocket. This would need to be discussed with your surgeon and there may have been anatomic issues that resulted in this appearance. 

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

Asymmetry in the medial fold

+1

There seems to be some asymmetry in the dissection of the medial fold.  This may improve with time as the breast implant stretches the surrounding soft tissues.  I would encourage massage of the area and close follow up with your plastic surgeons. 

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 29 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.