Should Breast Look Saggy After Breast Augmentation? (photo)

Its been 11 days since ive had my BA. (Silicone 400cc below muscle) My breasts look "boxy" and look as though the implant is sitting high on my chest and my actual breast is hanging from the implant. Will the implant "drop" enough to make my breasts look normal? Or was it placed too high on my chest? If so what can be done to fix this?

Doctor Answers 17

Wait three to four months for breasts to drop

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Your results appear to be normal for being so early on in your recovery. You still need to "drop and fluff", which refers to the gradual movement and change in shape that occurs to breast implants. 

When breast implants are first put into your body, they typically sit higher up in the chest. This is because it’s the path of least resistance – your body requires some time to adjust to their presence, regardless of whether they’ve been placed in a sub-mammary (between breast tissue and chest muscle) or sub-muscular (under both the breast and chest muscle). Immediately following surgery, you’ll find that your newly enhanced breasts appear very full and swollen, especially in the upper portion above the nipples. Your skin will most likely look very tight and your nipples may point slightly downward as well. This may make the shape and overall appearance of your breasts appear unnatural. As your body accommodates to your new implants, you’ll notice that your breasts will gradually look more and more natural – the way you hoped they’d be! Over the course of about three to four months, your body creates new skin to accommodate the additional volume of your implants. This natural process is called “tissue expansion”, and relieves the tightness you may be experiencing. It allows for the implants to settle more into a better position with the help of gravity. A gradual redistribution of volume from the upper to the lower breast occurs, resulting in an enlargement and rounding out of the lower breast.

Although it's often called "dropping", it is more like "redistribution". The "fluffing" part refers to the impression that the lower breast enlarges and that your skin softens with the creation of new tissues. The extent to which this occurs depends on several factors, including the implant size, the tightness of your skin, and your body shape.

Needing a lift from the start

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Your preop photo shows a downwardly displaced and point nipple.  This will not be fixed by implants alone.  The good news is that you can heal for 6 months and see if the final look is okay and if not, do the lift then.

Postoperative Breast Augmentation Results

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From your preoperative photos, you have a relative excess of breast skin (whether this is the natural shape of your breasts or you have had children) when compared to your pectoralis muscle. When you place an implant beneath the muscle in a situation such as yours, the muscle needs to relax more that the existing breast skin. This takes time. As a result, you will see this improve as the muscle relaxes to the degree that your breast skin is currently. Although this is not accurate for all patients, 11 days is far too early to make a decision or get overly concerned about your results. You will likely see an equalization of your implants as the muscle catches up to your skin. Be patient and stay in touch with your surgeon.

Best of luck!

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Should Breast Look Saggy After Breast Augmentation

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It is still quite early into your healing and it's not uncommon for #asymmetry as each breast heal quite differently. One breast may swell more, feel more uncomfortable, or have a different initial shape. After complete #healing, they will be more similar and natural. #Healing will continue for 2-3 months following your #breast procedure. Your doctor may also require you to move or massage the implants within the breast pockets during the #postoperative period. (#Textured implants do not require breast massage.)

Typically, it's best to wait 6 to 12 months depending on the reason for #revision.  Matters such as sagging or drooping  and size change will not improve with time. Most importantly, communication  and asking questions of your surgeon and the staff are key. Another element to a satisfying result of your #augmentation is realistic #expectations.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Post-Operative Elevation of Implants

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The period of time immediately following breast augmentation surgery is characterized by rapid change. During this dynamic phase of healing, swelling, muscle spasm and the healing process itself all contribute to changes in the appearance of a woman's breasts. In some cases, swelling and muscle spasm can displace the breast implants in a superior direction when implants are placed beneath the muscle. Based on your history and pictures, this may be a distinct possibility in your case.

In some cases, superior implant displacement may be due to inadequate dissection of the muscle insertions of the inferior portion of the breast pocket. There's no evidence that this has happened in your particular case.

With time, assuming adequate pocket dissection, these implants will probably return to a more normal position. When this happens, the breasts won't appear to be saggy. Sometimes, the use of a bandeau superiorly and massage may facilitate this process.

It may take 3 to 6 months for these implants to drop into a normal position. If no progress has occurred by then, revisional surgery may be necessary. This would involve recreating the lower portions of the breast pocket.

It's important to have good communication with your plastic surgeon. Make sure he is aware of your concerns. He's familiar with the specifics of your surgery and will be able to give you appropriate direction.

Typical breast shape shortly after surgery

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This is typical of the earlier stages of breast augmentation recovery. It usually takes about 4 months for a more natural looking breast to appear. You should see the improvement gradually appear.

Ronald Levine, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 25 reviews

Breasts up high 11 days post op

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Thank you for the photos.   It is still too early to say anything definitive.  They are a bit high right now, which is normal.   As the implants settle into position, things should round out. Please do inform your plastic surgeon about your concerns. He/she may want to examine you. He/she may have a message or other protocol that he/she may find helpful.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

High implants after breast augmentation

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You are still early in the post-operative process when implants are high.  Have you discussed with your surgeon about massage, stretching, or wearing a bandeau to help them fall? 

Boxy breasts after an augmentation

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You may want to get a band to help push down the implants.  Also, talk to your plastic surgeon about massage techniques.

Did I need a lift?

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From your photos it looks like 1. You have several more weeks to go before your implants drop down into position. Massaging the implants downward will help some but your main ally here is time 2. A lift might have helped some but borderline patients like you often prefer to risk the outcome a bit in order to avoid the scaring from a lift. 3. If you still don't like the shape in a year you can get a lift without any issues as a separate procedure. Given you are only 11 days out I doubt this will be necessary. Best of luck, Dr Kerr

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.