Does a subfascial breast augmentation give instant results?

Question

Does subfascial breast augmentation give you instant results, or do the implants settle and drop with time?

Daniel Barrett, MD · Answer

Dear siihii22,
breast implants will always need some time to settle. Implant placement doesn't play a significant role. 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Semih Yildiz, MD, FEPOBRAS · Answer

Subfascial breast augmentation gives an immediate increase in breast volume, so you will see a change right away. However, the first look after surgery is not the final result. Swelling, tight skin, muscle/fascial support, and the new implant pocket can make the breasts look higher, firmer, or less natural early on.

With time, the swelling decreases and the lower pole of the breast stretches and rounds out. This settling process is often called drop and fluff, although the amount of change depends on your starting anatomy, implant size and profile, tissue quality, incision/pocket technique, and whether the implant is truly subfascial versus another plane.

Many patients see a noticeable improvement in shape over the first 6 to 12 weeks, with continued refinement over 3 to 6 months. In some patients, especially with tighter skin or larger implants, final softness and position may take closer to a year. Follow your surgeon's instructions about bras, massage if recommended, activity, and follow-up appointments, and avoid judging the final result too early.

J. Timothy Katzen, MD, FACS · Answer

Hello SIIHII22,
Thank you for your inquiry about subfacial breast augmentation and whether it provides immediate results. When we talk about subfacial placement in breast augmentation, it usually refers to placing the implant beneath the fascial layer, which covers the muscles. This is different from submuscular placement, where the implant is placed under the pectoralis muscle.
Subfacial breast augmentation indeed offers immediate visible results post-surgery. The implants are positioned just beneath the fascial layer, offering a natural look and feel while avoiding some of the issues associated with submuscular placement, like muscle contraction affecting the implant's position.
However, like any surgical procedure, some initial swelling and settling of tissues are expected. While you can see the change in breast size and shape right away, the final results and the exact settling of the implants might take a few weeks to fully materialize. This settling period allows the breast tissues and skin to adjust to the new implants.
It's important to have realistic expectations and understand that while the change is immediate, the full outcome of the surgery might evolve slightly as your body heals and adapts to the implants.
I hope this information helps clarify your understanding of subfacial breast augmentation and its immediate impact. Consult with your plastic surgeon to discuss any specific concerns or questions you may have about the procedure.
Sincerely,
Dr. Katzen

Payman Danielpour, MD, FACS · Answer

Thank you for your question
Yes the nice thing about a subfascial aug is that you get immediate results with no animation deformity.  It is an excellent methoid for breast augmentation and I have been doing it for the last 15 years.

Jordan Kaplan, MD · Answer

A subfascial breast augmentation will settle however it will take 2-3 weeks versus a sub muscular breast augmentation which takes 2-3 months. Immediately following surgery you will have a very good idea of your final result.

Karl William Schwarz, MD · Answer

Implant settling in my opinion is an older phenomenon that we don't see as much of anymore. Most of the times we still see it is when a very large implant has been used.

The question then becomes what causes implant settling and why aren't the implants in the correct position to begin with. We used to see long times for implant descent quite a long time ago because the implant was always placed under the muscle and the muscle was released from the chest wall to allow for the implant to get into the correct position, but because we didn't release the muscle all the way to the middle of the chest the muscle kept the implant in a higher position and it required time for the muscle to stretch to allow the implant to come down ('settle').

Today we release more of the muscle and that's why implant settling is kind of a thing of the past. Of course ALL implants, regardless of their position of placement, will settle a little bit--that's just the natural course of healing but these are more subtle changes also related to swelling and healing.

The reason is most of us have been dividing more of the pectorals major muscle so that the implant is in the correct location from the beginning. For a subfascial augmentation there is no dividing of the pec major muscle, because the implant sits on top of the pectoral major muscle so there is really no settling to do at all and patients usually look very good very quickly after a subfascial or sub glandular augmentation.

Connie Hiers, MD, FACS · Answer

The implants will still need to settle some and swelling from surgery will need to subside. Plus, your tissues have been stretched and will need to relax.

Jon S. Wilensky, MD · Answer

Subfascial breast augmentation is a surgical technique where breast implants are placed beneath the fascia, which is a layer of connective tissue covering the muscles of the chest. Compared to other placement options like subglandular (above the muscle) or submuscular (below the muscle), subfascial placement offers certain advantages, such as potentially reducing implant visibility and rippling while providing more support for the implants.However, like any breast augmentation procedure, the results of a subfascial breast augmentation may not be fully apparent immediately after surgery. While there may be some initial changes in breast size and shape, it's common for the breasts to appear swollen, bruised, and possibly distorted due to postoperative swelling and tissue trauma.The final results of a subfascial breast augmentation typically become more apparent as the swelling subsides, and the tissues heal and settle into place. This process can take several weeks to months, during which time the breasts gradually take on a more natural appearance and feel.It's essential for patients to have realistic expectations and understand that it may take some time to see the full results of their subfascial breast augmentation. Additionally, following the plastic surgeon's postoperative instructions, attending follow-up appointments, and allowing adequate time for healing are crucial steps in achieving the best possible outcome from the procedure.

Camille Cash, MD · Answer

All breast augmentation procedures will have some degree of instant results as the volume from the implants will be present.  Regardless of the implant placement there will be some degree of settling as swelling is common and expected after surgery.  I encourage you to discuss your concerns with your surgeon.

Justin Booth, MD · Answer

Yes, subfascial implants will settle over time. As the swelling goes down, the breast tissue and skin will be more compliant. To your point, however, is not as dramatic as with under the muscle placement and they tend to settle faster. 
Justin Booth, MD FACSAustin Plastic Surgery Institute

Does a subfascial breast augmentation give instant results?

Answers (10)

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