Is It Normal for Breast Implants Placed Under Muscle to Still Be Firm After 5 Months

Question

Is It Normal for Breast Implants Placed Under Muscle to Still Be Firm After 5 Months?

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Implants placed under the muscle will typically soften nicely over the first 3-4 months.  This softening occurs once the muscle has stretched and relaxed and swelling has subsided, and is generally encouraged with daily breast massages.  Depending upon the size and type of implant placed, this softening may never resemble the soft nature of a natural breast.  Larger implants, especially large saline breast implants with little soft tissue coverage, tend to feel a little firmer than smaller, silicone gel implants do.  I would recommend following up with your operating board-certified plastic surgeon as you are complaining of firmness at the 5 month post-operative mark.  It is possible that it might take a little more time until your implants have fully settled and softened, but it would be important to rule out any capsular contracture formation and a physical exam is necessary to do so.  I hope you find this helpful.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  Congrats on the surgery.  It may take months for the breasts to soften, and they may never soften to the pre-surgical state.  In addition, the greater the implant to breast tissue ratio, the more the implant will affect the longterm firmness (or softness) of the breast. Given the timeframe, I would revisit with your plastic surgeon to assess if this is normal firmness or whether there is a capsular contracture that is contributing to the firmness.

Richard H. Tholen, MD, FACS · Answer

After 5 months, most of the swelling and firmness associated with breast augmentation (either above OR below the muscle) should be resolved, but it can take up to a year for full sensation return, scar maturation and softening (internal and external), and "final" implant position and softness. But at this point in your recovery, only subtle or minimal additional changes can be anticipated.

	So how firm is "firm?" This can depend on the type of implant (saline vs. silicone), cohesive vs. investigational solid silicone "gummy bear" implants, the size of the surgical pocket, your own degree of muscularity and the thickness of your pectoralis muscles, and whether or not you have begun to develop capsular contracture.

	These are impossible to answer without more information and a physical examination. This is best done by your own plastic surgeon, who can answer your questions better than any of us here on-line. Make an appointment to see your surgeon! Best wishes!

Steven Wallach, MD · Answer

Usually by four months or so the breast soften up, but this varies by the amount of expansion from the implants ( size of implants and original laxity of the skin). Keep a close eye on them with your surgeon.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Unfortunately, it is not possible to give you good advice without direct examination;  &ldquo;firmness&rdquo; means different things to different people. Generally speaking, breasts "soften" over the course of the first 3 to 6 months after surgery.

	I would suggest follow-up with your plastic surgeon to evaluate the breasts and rule of complications.

	Best wishes.

Brooke R. Seckel, MD, FACS (retired) · Answer

You are right to be concerned and should see your Plastic Surgeon. Typically Sub-muscular Breast Implants are firm for the first 3-4 months, firmer than Breast Implants placed under the breast gland.

	However with massage and normal Chest Muscle activity the Breast Implants will soften significantly by 3-4 months.

	See your doctor and ask if he/she is concerned about capsular contracture. Ask about breast implant displacement exercises

Is It Normal for Breast Implants Placed Under Muscle to Still Be Firm After 5 Months

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