No, it’s not the latest iteration of Elle Woods’ iconic “bend and snap” move: “drop and fluff” is an informal term that describes the process of breast implants settling after an augmentation—and it’s an important part of the recovery process. Here, top plastic surgeons explain what the “drop and fluff” is and how it will affect the end result of your breast augmentation.
“Dropping” refers to implant settling
Immediately after an augmentation, breasts look very round and sit high on the chest; eventually, they take on more of a teardrop shape. Attribute this to good old-fashioned gravity. “As time goes on, the bottom of the breast implant will settle more toward the bottom of the breast area,” explains Dr. Jerome Edelstein, a certified plastic surgeon in Toronto. It’s not, necessarily, that the implant itself is moving downward significantly—though it may drop a centimeter or two—but more so that it’s being redistributed and settling into its final position.
The changes happening to the surrounding tissue also play a role, as does the swelling that inevitably occurs post-surgery. “After a breast augmentation, there’s a lot of swelling on the upper side of the chest, where the chest wall turns into the breast,” explains New York City board-certified plastic surgeon Dr. Melissa Doft. “Because that swelling is higher up on the breast, as it subsides, it creates the illusion that the implant has dropped.”
“Fluffing” refers to skin expanding
No matter whether you put a breast implant under or over the muscle, there’s a lot of expansion and stretching of both the tissue and the overlying skin, after the fact, as well as scar tissue that’s formed around the implant, says Dr. Ashley Amalfi, a board-certified plastic surgeon in Rochester, New York. This tissue is tight and hard because it’s being pulled taut, and it takes time for the skin to stretch out and soften. “As it expands, you get not only a more convex appearance, but the breast also begins to feel softer,” she adds. (It’s worth mentioning that the aforementioned swelling is also part of the reason that breasts feel so hard post-surgery.) Picture one of those mattresses that come in a box. When you initially pull it out, it’s tight and stiff and crushed together; as it relaxes, it takes on its natural shape and, quite literally, fluffs up. The same thing is happening with your breasts and the implants during the healing process.
Related: Silicone vs. Saline Breast Implants? 5 Things to Know About Picking the Right Type for You
“Dropping and fluffing” is an ongoing process
“The breasts you see one week after surgery are not indicative of what your end result is going to be,” emphasizes Dr. Edelstein. So how long does the “drop and fluff” take? About three to six months is average, though it takes a full year to really get the final look, notes Dr. Doft. And keep in mind that changes are ongoing throughout this time. “You’re going to see a difference from week to week, it’s just that the complete process takes months,” says Dr. Edelstein.
Factors such as how big your implants are, your natural breast size, and whether the implant is placed under the muscle all play a role in how long the settling/healing process lasts. It typically takes longer for someone who is naturally smaller-framed and didn’t have large breasts to begin with than it would for someone with larger breasts or who is postpartum, with breast tissue that’s already been stretched out, notes Dr. Edelstein. As a general rule of thumb, the bigger the implant, the longer the dropping and fluffing period. Implants that are placed under the muscle also take longer, because they have to push against the muscle and force both it and the tissue to stretch, says Dr. Doft.
Some asymmetry is normal
Augmented or natural, breasts are sisters, not twins. “While the ‘drop and fluff’ is a normal part of the healing process, the exact reaction can differ from breast to breast,” says Dr. Amalfi. Dr. Edelstein agrees: “Breasts progress at different rates. You really have to think of it as two separate surgeries, with two different healing processes.” Point being, don’t be alarmed if your breasts are slightly asymmetrical during this initial three- to six-month period.
You should be concerned, however, if the asymmetry is extremely noticeable—that is, if one breast is dropping and fluffing nicely and the other one isn’t changing at all, says Dr. Edelstein. Similarly, see your doctor if one of your (or both) breasts is becoming harder and firmer rather than softer, warns Dr. Amalfi. Both situations can indicate capsular contracture, a complication in which excess scar tissue forms around the implant, likely due to some type of bacteria, explains Dr. Doft. If there’s no capsular contracture or other complication and it’s just that the breasts are progressing at very different rates, there are other things your doctor may advise you to do. This includes options such as massage or wearing a compressive band, to help speed up the process of the implant settling into its final spot, she adds.
