Techniques for Settling New Breast Implants?

I'm 4 weeks post breast augmentation surgery, and my surgeon wants me to sleep with a workout bra pulled up above my breasts to help push them down and drop more below my nipples. The first three weeks, I was in plastic bandages to keep them up. I had 300cc silocone under muscle, but was told that during surgery, my doctor decided to do lift because of my skin.

None of my friends have heard of this technique and their breasts settled in. Is this normal? My breasts do seem too high and my nipples too low. Are there other "techniques" for making the breasts settle the way my doctor wanted it?

Doctor Answers (26)

Many techniques, but time will be your best friend

+5

It's very common for implants placed under the muscle to seem too high early on after the augmentation-- this is due to anatomic reasons as well asthe swelling of the muscle that occurs during and after the procedure. We all have different ways to help implants settle into their final position, and in most cases it just takes time-- sometimes a few weeks, on rare occasion longer.

My advice would be to relay your concerns to your surgeon, but listen to his advice--chances are you will have a great result, but it will take some patience and time.

Dr. S


Seattle Plastic Surgeon
5.0 out of 5 stars 103 reviews

Techniques to Help Implants "Settle"

+4

There are different techniques that surgeons use with their patients, including:

  • wearing an elastic garment that pushes down on the upper pole of the breast (Ace Wrap, specially designed bra, specially designed elastic strap, or what your doctor has recommended
  • manipulation or downward massage
  • sleeping prone(on your belly and chest)

These are all different ways to apply downward pressure on the implant to get the skin and muscle of the lower pole of the breast to expand to allow the volume of fluid (saline or silicone) in the implant to settle to the bottom of the implant.

This is different from an implant malposition, where the implant itself is just sitting too high on the chest.

If you can fell the bottom of your implants at the breast crease, the implants are not "too high;" it's just the fluid being displaced to the top of the implant by the tightness of the skin and muscle.

You may see one side "settle" sooner than the other: this is normal.

Follow your surgeon's recommendations, and allow at least 6-8 weeks for "settling to occur."

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 14 reviews

Sounds like an inexperienced surgeon

+3

Making a decision intraoperatively to do a lift is unusual. It should be clear to an experienced plastic surgeon preop when a lift will be required.

Having your implants low and then high is also strange. Basically, you will settle over 6 months and know what your final result will be. Alternatives at that time include several options if the result doesn't meet your satisfaction. If at that time, if the breast looks low on the implant and the implant isn't sitting too high on the chest wall, you will need more lifting. If the implant is sitting too high on the chest wall, it will need to be surgically moved down. You also don't want to push down too hard on the implants because you don't want to have them settle too low and need further surgery to correct the bottoming out that has occurred.

Sounds like you need to stay in very close contact with your doctor and be monitored frequently for the next few months! Unfortunately, there are doctors out there who are afriad you won't come to them if they tell you that you need a lift plus the implant. The lift causes scars and costs more so some doctors hope to get by telling you that you dont' need a lift. Implants DON'T lift the breast, they only add volume. A lift is the only way to elevate the nipple and reshape a sagging breast.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

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Settling Breast Implants

+2

Thanks for your question -

There are specific bandages and dressings that can be supplied by your surgeon to help put downward pressure on your breasts.

Massage may also help.

In all likelihood the most important factor is time. As swelling comes down and gravity does it work the position of your implants will improve.

Usually by 3-6 months the breast implants have found the correct position.

I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 28 reviews

6 months to settle

+2

Giross,

Your description of the decision to perform a "lift" sounds dubious unless you had this conversation with the surgeon preoperatively. Implants will descend with time and may take 6 months to reach their final destination. Wearing a tight garment over the top part of the breasts may speed the process of implant settling. I use a breast band on my patients that need this intervention. It can be worn night and day and may be more comfortable than pulling a sports bra up. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

That is a normal technique for pushing the implants down

+2

giross,

A few issues... I hope that the doctor explained to you about the lift BEFORE your surgery. Many times there is a possibility of having to do a lift, but you should be well aware of this before your surgery.

As for your implants settling, it is common to wear a special bra or strap to help push the implants into place if they are riding high. It is curious that initially you were told to push them up and now you are told to push them down. However, your doctor may just be trying to get them into perfect position for you.

Good luck with your recovery. It takes about 3 to 6 months for your implants to completely settle.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Compression devices are an accepted technique for helping breast implants drop

+2

Giross,

it is common practice to use a compression device to encourage breast implants to fall or be pushed lower after breast augmentation.

A common wrap called an "upper pole wrap" is commonly used, but your bra will work.

Downward massage can also help.

The description of the position of your breast implant sounds as though you may have needed a breast lift to put the nipple in a normal position.

When breast augmentation is done without a lift in this situation, the implant always looks high and pushes the nipple areola complex further down.

Hopefully the upper pole compression and massage will help your implant move down below the nipple areola complex.

If it does not, you may need a breast lift.

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

"Settling" breast implants after surgery

+2

It sounds like you have high riding implants which can sometimes be repositioned in the early post op. period by the use of a bandage or special garments. However, a consultation would be necessary to ascertain the surgical realities and alternatives

Barry H. Dolich, MD
Bronx Plastic Surgeon
5.0 out of 5 stars 1 review

Massage

+1
I would not wear a bra.  I would have you massage your implants down.  The use of postoperative appliances is not necessary in my opinion.  

Gary Lawton, MD, FACS
San Antonio Plastic Surgeon
5.0 out of 5 stars 23 reviews

Techniques for settling new breast implants?

+1
Hello! Thank you for your question! Breast augmentation is a procedure often sought by women to increase size, add upper pole fullness and projection along with improve shape and symmetry of her breasts. Women who have the breast augmentation done report increased self-confidence, self-esteem, and more comfortable with her body. In fact, it has been the most popular procedure in plastic surgery in the US for the past few years.

It typically takes 6-8 weeks for the swelling to resolve and usually 2-3 months for the implants to settle into their pockets. In general, implant size does not correlate with cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size or implant size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance. Your breast width is the most important measurement. Discuss with your surgeon implant massage/displacement exercises and the possibility for a bandeau to keep your implants down. You are still early in the postoperative period and awaiting this time frame will give enough time to see your results. Maintain your follow-up appointments and continue with your postoperative instructions/restrictions given.

Hope me that this helps! Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 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.