Breast Implants That Do Not Settle

I had breast implants revision 9 months ago. After having silcone implants for 20 years, I decided to go with saline. My surgeon suggested to put the implants under the muscle since the last ones I had were placed over the muschle. The problem is that since I had them done, they're no longer as big as the ones before (even though my surgeon says they're bigger) and they're not settling and their position is too high. I have done all the massaging and wore bands above the breasts but none has helped. Do I have to go back to this doctor and pay for him to fix this poor job? What else can I do?

Doctor Answers 35

Breast Implants Not Settling Caused by Submuscular Placement and Ptosis or Breast Sag

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Thank you for your question. Breast Implants do settle and are often high for the first 6 weeks after breast Augmentation. This is especially true with submuscular implants.

Because your breasts have aged since your original implant, the breast has sagged down, a condition called Ptosis.

Placing the new implants under the muscle is an appropriate choice. However because the breasts have sagged, a breast lift will likely be necessary since the implants have not come down after 9 months.

Trying to release the implants to move them down risks a "double bubble" if the crease underneath the breast is violated. A lift is a better option

At 9 Months, Revision is Advisable

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Your photograph shows excessive upper pole fullness.

This can be corrected with a surgical release of the capsule to allow the implants to "settle."

Discuss with your surgeon.  Each practice has a different policy regarding costs for revision.

Breast implant position

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Your breast implants seem to be positioned too high. I don't believe that they are going to settle much without surgical intervention. Unfortunately, you will most likely need to have revision breast augmentation surgery.

Please visit your surgeon

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Either you have an early bilateral capsular contracture (unlikely) or your implants are too high or too high in profile. One of these is an explanation of why your result is currently not satisfactory. Start with your surgeon and see what they have to offer you. If you are not satisfied with the answer, go to other surgeons and get their opinions. Don't have any more surgery until you are confident with the doctor.

Breast implants should look great immediately.

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I am sorry to tell you that the notion that breast implants have to settle is a myth. Your breasts should look great right after surgery. You will need a revision in six months.

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

Breasy Implant position issue

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I am sorry to hear that you are having problems with your implants. You may have a capsular contracture, or the pocket was not opened up enough or the muscle adequately divided inferomedially. Needless to say, they should be corrected.

Breast Implant Malposition

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After 9 months, your implants should have dropped by now.  I don't think that additional massage, band wearing etc. is going to be of any benefit at this point.  It appears that you are going to need additional surgery to lower the pockets and therefore lower the implants.  As others have mentioned a capsular contracture on both sides could also cause this appearance, but that would be uncommon. 

If your original PS does not give you an answer that you are comfortable with, then you should consult with a few others (Board Certified PS).  Good Luck, Dr. Weider

Breast Implants That Do Not Settle

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Hello gidget12, The placement of your implants does seem to be a bit off. More so, you needed a mastopexy with this revision. Your areolas are at or or below your breast crease, meaning your breast tissue has drooped after 20 years. It's natural aging. But with new implants that breast tissue is now "dropping off the cliff" (your implant). If you are also unhappy with the size, I would meet with your surgeon again. After 9 months you've waited plenty of time to safely have a revision. If after that meeting you still do not feel confident moving forward with them, please make sure you seek out the help of a board certified surgeon with much experience doing revision surgeries. Good luck to you.

Correcting Implants That Do Not Settle

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From time to time, implants -  when placed under the muscle - do not fall adequately into the lower portion of the breasts. The photo you submitted suggests that the implant hasn’t fully dropped as expected. It is possible that a secondary procedure to release the breast tissue and/or the muscle in the lower portion of the breast will improve this condition. It is also possible that excessive scar tissue has enveloped the implant, causing it to sit too high. In this circumstance, removing scar tissue can also improve the appearance of the breast by lowering the implant. Finally, if there is loose breast tissue (sagging) over the implant, then a breast lift might be the desired approach. All of these possibilities can be evaluated by a plastic surgeon accustomed to doing corrective revisional breast implant surgery.

Breast implants that do not settle?

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Hello! Thank you for your question! You are still early post-procedure. Your appearance looks typical at this stage and will continue to improve as the swelling subsides and the implants continue to settle into their desired position. This usually proceeds over the next several weeks as the lower pole skin/breast stretches to accommodate the implants. Follow-up closely with your surgeon for additional restrictions/instructions and the potential use of bras/garments or massage that may encourage the implant to settle appropriately. If still displaced after this time, a surgical procedure may be necessary to further open the pocket and bring the implant(s) down. Hope that this helps! Best wishes!

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.