Do breast get bigger after implants settle or do they get smaller because they are swollen? (photos)

Question

I had my breast augmentation done this week and I think my boobs came out smaller than what I wanted so when I told my doctor he said that they would look bigger once they settled

Young R. Cho, MD, PhD · Answer

Thank you for your question. During the post-operative period the breast are swollen, and the breast implants appear in a much higher position. Over time they descend and fills out the lower half of the breast. It may take several months for this to happen and can be encouraged with breast massage and compression. After the swelling goes down the breasts will appear smaller.  However, as the implants settle, it may appear that the breast enlarges as the lower aspect of the breast fills out (at the expense of the upper portion of the breast).

Larry S. Nichter, MD, MS, FACS · Answer

Two things happen and seem paradoxical. As as the swelling  goes down there will be some shrinkage but at the same time as the muscle relaxes your breast projection grows. In general the breast shape and size proportionality improves..Breast implants initially after surgery when placed in a submuscular position often give superior fullness that corrects itself with time, the "fluff and drop" phenomena. In reality the pectoralis major muscle takes a while to adjust its size to accommodate the implant as well as occasional muscle spasm which keeps the implant projection higher than its final resting shape. Additional variables include:laxity of skin, size difference during prior pregnancies, position of implant,size of muscle, and size of implant.As the muscle relaxes the projection of the implant often increases and the breast shape improves. Massage and use of a superior placed elastic strap can often make this process go faster.

Roy Ng, FRCS(Plast) · Answer

It is unlikely that your breasts will look bigger once they have settled. The final consistent size will be apparent at about 3 months, after the swelling has gone down and the breasts have 'dropped' a little. At that point, they will most likely appear smaller and lower than they are currently, but not by a huge amount.

Steven Wallach, MD · Answer

Implants will unlikely appear larger when they drop, in fact they may look smaller when the swelling subsides.

Darryl J. Blinski, MD · Answer

I would not venture a guess as to the possible appearance after settling to a larger size. In fact I doubt it. But we will have to wait and see...

Gustavo E. Galante, MD · Answer

In general, the final consistent size after a breast augmentation procedure can be evaluated after 3 months time. By this time the muscle (assuming they are under the muscle) has relaxed and the skin envelope has stretched out enough. So most patients feel they are slightly smaller as the implants have settled inferiorly. However, breast implants don't change in size unless they are ruptured.

Jeremy Pyle, MD · Answer

Kind of.  The implants, especially when placed beneath the pec muscle, will tend to ride up over the first week and then gradually settle lower into a position behind the breast tissue.  The volume doesn't get bigger, in fact it gets smaller as the swelling disappears.  The appearance of the breast, however, gets larger as the implant fills the area behind the breast tissue rather than above it.  Things appear to look exactly how one would expect at this point in your healing.Best,Dr. Pyle

Jeffrey K. Scott, MD · Answer

Most of the swelling after breast augmentation occurs in the sternal/cleavage area as well as the ribcage area just lateral to the breast  (not the breasts themselves). Also the skin of the breast is very tight early postoperatively after breast augmentation which reduces  forward projection. All of this tends to blunt the new augmented appearance of the breasts until swelling subsides and the implants begin to settle downwards. Be patient, you will likely be very happy within a few weeks.

Peter E. Johnson, MD · Answer

As the skin envelope relaxes and the implants settle and center in the breast pocket patients do describe a fluff effect as the breast begins to feel fuller and projection improves. This may not translate into a fuller cup size, but the look will be better.

Henry Mentz, MD, FACS · Answer

It looks like you will have a great early result and it will likely take a few weeks to settle. Usually in patients who have not had children or been previously heavier, the breast skin and muscle is tight. Therefore early after breast augmentation the implants sit high and flat as the muscle is in spasm and the skin brassiere is tight (like wearing a sports bra). As the skin and muscle softens the implant settles lower, the upper pole will become less full and round and the lower pole will become more full. There might be 5-10% swelling to resolve, and the shape will become more soft and natural. Your photos look great though limited and I would expect a nice result. It is always helpful in choosing sizes to try on various sizes and the size that looks best for you will be about 10% smaller than the size utilized. So if you choose 300 ccs in your bra prep, then usually your doctor would use 300 plus 30 or a 330cc as a final size. When you size an implant in your bra there is empty space around the implant that is unaccounted for and therefore you must add a bit. Stick to your doctor through your recovery and rely on his/her advice concerning your surgery. Best of luck to you.

Do breast get bigger after implants settle or do they get smaller because they are swollen? (photos)

Answers (11)

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