You won't really know until after 6 months...
Being that you are already four months postop your implants would have settled by now. It seems that your implants are high and your surgeon is trying to move them down using wraps. You breast implant pocket capsule is getting quite mature and will probably not move much. I have seen and dealt with this problem many times. I would wait until the six months are over and then fully evaluate your clinical situation with your surgeon. At six months, you will have one of the following scenarios to deal with:
- Your implants are equal in position and you are happy
- Your implants are unequal in position but the breast tissue sits squarely on top of each implant (no sag)
- Your implants are unequal in position and you still have sagging breast tissue that is below the center of the implant
- Your implants are equal in position and look good on your chest, but your breast tissue sags below each implant.
If you experience situation #1 - Congratulations!!!
If you experience situation #2 - You will need to discuss with your surgeon the need for a pocket adjustment procedure to get them closer to the same position. If one implant is perfect and the other is too low, then the low one needs to be raised. If one implant is perfect and the other is too high, then the inframammary fold needs to be lowered to bring the high implant down to match the good one.
If you experience situation #3 - you will need the same procedure described in situation #2, with the addition of a breast lift to get the breast mounds to rise back up squarely on top of the implant.
If you experience situation #4 - you will need a breast lift only to put the breast tissue back squarely on top of the implant.
Good luck :) Dr. Shah
It is common for implants to take some time to settle into position, and it's common for the process to be asymmetric.
At 4 months post-op, you might still see some improvement.
Continue to work with your surgeon and ask him his expectation and time course, before he would recommend revision.
Revision is certainly a possibilty
Given what you have described, I would not be surprised if you need a revision in the future. It sounds like you may have had some extra skin or breast ptosis before your procedure, which can often be addressed by performing a breast lift at the time of the augmentation. If this was the case, it may be difficult to now manipulate the implant to make it drop into the proper position, in particular if the implant was placed behind the muscle.
My advice would be to wait a minimum of 6 months after your surgery to consider any revision. Discuss with your doctor your concerns and he will likely give you one or more options for surgical revision.
If you do not see the results you desire in the next few months, you will likely need a revision.
I have found that it usually takes about six months for the breast implants to properly settle. However, what you describe presents two issues. First, if one implant is higher than the other, you may require a revision surgery to fix that asymmetry. While wearing straps may help, at this point, I would not expect much difference. Second, the "loose" skin under the breasts, may indicate that you also need a mastopexy or breast lift. While the implants may settle somewhat, if there is breast tissue hanging off of the implants, this is unlikely to resolve without further surgery.
David Shafer, MD
Shafer Plastic Surgery
Time for final breast augmentation shape to occurr
It is hard to know without photos but it sounds like you may need a revision. The revision may consist of
1) lowering the pocket
2) changing the implant size or diameter
3) getting a lift
All three of these may be solutions to potential issues you are describing.
All the best,
Uneven settling of breasts.
It is quite common for breasts to settle unevenly and have one descend faster than the other. Different types of exercises may be used for thise purpose as well as the use fof specialized bands.
Implant settling after breast augmenation
Typically it takes breast implants 3-6 months to settle completely after a breast augmentation. Breast straps (bandeau) which place downward pressure on the implants, aggressive massage, and patient observation are effective in treating most cases of early asymmetry. If there is still considerable asymmetry after six months, a revision may become necessary.
Breast Asymmetry after Breast Augmentation
Breast Augmentation results will often continue to settle up to about 6 months. Asymmetries with regards to superior fullness and breast folds can commonly be manipulated with massage and bandeaus that force the breast implants into a desired position. In very muscular patients, a muscle relaxant can help facilitate correct positioning of the implants in the created pocket. Common causes of breast implant asymmetry are pockets that are not of similar dimensions, an early capsular contracture, and an inframammary fold that has fallen from its desired position. At this point I would discuss your concerns with your Plastic Surgeon, but give it another few months to make a decision. If you do not like what they have to say, I would seek another opinion. Good Luck.
Settling occurs for 3-6 months, be patient.
The period of time following breast augmentation surgery is
characterized by significant change.At
this time, swelling, muscle spasm and the wound healing process can all alter
the appearance of the breast.
cases, superior implant displacement may be due to swelling and muscle spasm
when implants have been placed beneath the muscle.In other cases, superior implant malposition
may be related to inadequate dissection of the muscle insertions of the inferior
portion of the breast pocket.
time, assuming adequate pocket dissection, these implants will often drop into
their normal position.This process
usually takes about 3 to 6 months.If no
progress has occurred by then, revisional surgery may be necessary.This would involve recreating the lower
portions of the breast pocket.
history suggests that progress has been slow and that your breast implants are
still relatively high.For these
reasons, consultation with your plastic surgeon is appropriate.Under these circumstances, revisional surgery
may be a distinct option for you.
Breast Settling After Breast Augmentation
Thank you for the question; congratulations on having undergone the breast augmentation procedure. Generally speaking, when breast augmentation is performed a “pocket” is created. Depending on the size and position of the breast implant pockets dissected, as well as the size of the breast implant used, it may take some time for the breast implants to “settle” into the dissected pocket. This process may be referred to as “dropping and fluffing”. It may require 3 to 6 months to occur. at this point, although easier said than done, I would suggest ongoing patience; you will find that time and patience will be your "best friends" over the next several weeks/months. Best wishes.