10 Days out from Surgery and Nipples Still Pointing Down and Breasts Look Slightly Square. Is This Normal?

Dear Stacey, In the early post operative period after a submuscular silicone breast augmentation, the pectoralis muscle and the tight skin both push on the inferior aspect of the implant, forcing the silicone up towards the top of the implant.  This displacement of the silicone in the implant plus swelling in the upper portion of your breast gives a temporary downward tilt to the nipple.  As the swelling in the upper portion of your breast subsides, and as the pectoralis muscle relaxes, the internal silicone portion of your breast implant will settle downward and your nipples will rise (there is an inverse relationship between the fullness at the top of your breast and the tilt of your nipple.

All that doctor mumbo jumbo being said, YES, your nipples turning down at this point is completely normal.  Time, gravity, perhaps a little pressure from an ace wrap, and all will be well.

Stacey, I'll bet you didn't look at one "during-recovery"photograph in the "100's of great before/afters" at your surgeon's office! That is true in my office as well--patients would be "shocked and appalled" in some cases, and at least mildly surprised in others, but would be pretty uniformly amazed at how remarkably things change over time during the healing process.

You too will soften, settle, and drop over time as your implant position moves down behind your breast tissue, and your firm and swollen incision areas stretch and round out. This will certainly occur (it does so in every patient, just at different rates), and your surgeon may have taught you implant movement exercises to aid in this process. He or she may also have you wearing an elastic bandeau for part of your day or night, and going braless for the remainder, all to help the tissues soften and round out as your implants drop behind the breast tissue into their final position.

This whole process takes time, and you should not be concerned at this point in your recovery. If you checked with your surgeon, you would discover that all of those great results photos were taken at different times corresponding to different rates of this natural process occurring! This will be you too. Fear not, and follow your surgeon's advice. Best wishes! Dr. Tholen

10 days after surgery your body is still going through changes.  In general I tell my patients to wait about 3 months to see the final shape and position of their breasts.  At this stage the shape is distorted with swelling and the implants are still going to descend more.  Be patient.

Be assured that you are very early in your recovery and your final result takes months to realize.  Discuss your concerns with your plastic surgeon on your post op visit. Your immediate post op appearance should not diminish your confidence in your surgeon' s performance

At ten days it is too early to see the final result from a breast augmentation procedure.  Give it a few months to settle.

Depending on the size of the implant and the skin envelope a breast implant may take three months for the skin to relax and allow the implant to settle into place. We have patients stay in a band over the top of the breast for two weeks day and night, and sometimes longer. At ten days it is just too soon to tell.

It is very early in the recovery process at 10 days. You will continue to see changes that occur over the next 6 months. If you trust your surgeon, then patience is the proper course and you will likely see much of what you are concerned about resolve with time.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon