Bottoming out or Other Implant Needs to Drop 2 Weeks After Surgery?

I'm on my 16th day post breast augmentation. I was 34A pre-op. I have 350cc Mentor cohesive silicone breast implants under muscle, with transaxillary incision. I'm right-handed dominant, and my right breast was slightly slightly smaller than the left pre-op. Is my left breast bottoming out or does the right need to drop? Also, on the same breast, there is a notch or dimple--what is this and will it go away?

Doctor Answers 8

Unilateral pressure on the top of your right breast might resolve your problem

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All women have asymmetry of their breast with 80% of the time the left breast is lower and bigger than the right. There for the right breast is usually a bit higher and when the breast are enlarged with implants the right implant must be placed a little lower than the natural lower breast crease. This is usually quite tight and tens to push the implant up higher than on the left side. In oder to counter this tendency you can put a strap across the top of the higher breast which with time will hopefully stretch out the new pocket and allow for more symmetry. This is usually effective for up to 6-8 weeks but once the pocket has healed you will need further surgery. I often put the patient in a stretchy bra and then lift the cup of the bra over the top of the high ridding breast. The more time this is in place the better the chance to correct the problem. When breast are even than the two pockets are the same and you can stop the treatment.

Orlando Plastic Surgeon
5.0 out of 5 stars 17 reviews

I am afraid the difference in your breasts is permanent.

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I know this is not what you want to hear, but the difference in your breasts may be permanent. This happens more frequently with the axillary approach to breast augmentation.

Probably, the bottom of the pectoral muscle on the right needs to be released, so that the right breast implant can drop. This will also take care of the notch. I would wait six months, and then do a revision breast augmentation.

Also, if the difference is subtle, you may just want to accept the slight asymmetry.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Allow time for swelling to resolve and implants to drop.

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As another of my colleagues mentioned, it is hard to give you an accurate answer without seeing your pictures or examining you. I tell my patients it takes at least 6 weeks for there swelling to go down, and their implants to drop, following breast augmentation surgery. I would say by 3-6 months you should have a pretty good idea of how you are going to look. At that time, you can then discuss with your plastic surgeon whether any revisions need to be performed.

David A. Robinson, MD
Munster Plastic Surgeon
4.7 out of 5 stars 46 reviews

Just in the early stages of recovery

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One thing we can all agree on...your two breasts don't do the same things at the same times. I suspect you'll see changes in both breasts as the first two months go by. Try not to spend too much time staring at yourself in the mirror.

Robert Frank, MD
Munster Plastic Surgeon
5.0 out of 5 stars 43 reviews

Hard to tell without an exam

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It is difficult to give an opinion without examining you or seeing photos.

One of the problems that can occur with transaxillary augmentation, although it can happen with any augmentation, is the implant settling lower than you would like.

The other issue with the transaxillary approach is that is this happens, you will most likely requie an incision on your breast to correct it.

Discuss your concerns with you plastic surgeon.

Dr Edwards

The difference will stay

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If you had different size breasts, than placing same size implants will not correct the size difference. It is hard to comment without photos, but if the difference is small than probably is acceptable. The bigger issue is the notching or dimpling. This tells me that one implant is folded partially on itself and creates some notching. The dissected pocket is smaller that the implant dimension. At this point follow your plastic surgeon's advise, but there's the possibility that you might need a revision in the future if these issues do not resolve.

Breast implant differences

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Without seeing photos it is hard to tell what exactly is going on.  Usually the breast drop a bit even with textured implants.  One side may drop a bit more than the other.  DImpling is hard to define without seeing photos. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Hard to say without pictures

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I really can't evaluate your breast implant positions without pictures. In addition, 16 days is way too early to say anything about implant position -- you need to wait months unless the disparity is incredibly marked.

Just be patient. Wait and watch. Do the exercises your doctor recommends and and see what they look like at 2-3 months.

G. Gregory Gallico III, MD
Boston Plastic Surgeon

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.