Will Breasts Look Larger As Breast Implants Drop?

It’s not uncommon for patients to express concern about breast size in the immediate post-operative period.  Multiple factors make it impossible to assess breast size four days after surgery.  This is even more so when breast lift and augmentation are performed in combination.
Several factors affect the size of breasts in the immediate post-operative period.  These include swelling of the breast tissue, swelling of the surrounding tissue, settling of the breast implants and muscle spasm.  For several months following surgery each of these phenomena is undergoing significant change.  These factors interact in a complex manner to create a rapidly evolving situation.  It’s virtually impossible to make decisions about breast size until the situation has stabilized.
In some cases, it may not have been possible to place a larger implant at the time of the original procedure.  During surgical procedures it’s not uncommon for surgeons to make compromises to obtain the best possible aesthetic result.  In some cases, utilizing larger breast implants may cause conflicts with other aesthetic goals.  For instance having larger breast might create and unnatural look which may not be desired by the patient.  It may disrupt harmony, balance, and proportion with other surrounding structures.
It might also affect patient safety.  When breast lift and augmentation are performed together, a larger breast implant might compromise blood supply to the nipple areola complex.  All of these concerns might place limits on implant size with this procedure.
In most cases, resolution of post-operative swelling results in a decrease in apparent breast size.  Occasionally resolution of swelling in the surrounding tissues results in greater definition of the breast and the perception that they’ve increased in size.  The vast majority of patients are happy with their breast size after a brief period of adjustment.  Rarely secondary procedures are necessary for size.

The breasts do indeed tend to look larger after the implants fall.  At 4 days after surgery, you are so early that there is no need to worry.  The implants that you chose should put you in the desired size range.

Breasts do change shape and size over time and very often immediately after surgery breasts can look somewhat smaller.  As the soft tissues relax, the breasts can take on a fuller rounder appearance. My advice in your situation would be to give your breasts time to settle, watch, and see how they progress. There is always a balance between size and shape and longevity. Implants that are too large can cause recurrence of drooping faster and have other issues as well. 450 cc is a fairly large implant although this of course depends on the size of the patient. Ultimately, I would expect that you and your surgeon made a good choice if you had significant discussions about size and shape preoperatively and most likely your breasts will take on a nicer fuller rounder appearance as time goes on.

When you have any breast surgery, and certainly if you combine a lift with an augmentation, it takes months for the final appearance to emerge. It seems that your lift successfully repositioned your nipples and improved the droopy appearance. Your surgeon used an implant volume that would typically increase you from a B cup to at least a full C cup, so be patient (I also hate to base breast size discussions on cup sizes, since they can vary so much with different bras). Also keep in mind that larger implants are heavier. If you had used 550 cc implants, for example, you may experience stretching of your breast skin and tissues that much more quickly, with development of drooping once again. When I perform simultaneous breast lift and augmentation, in most cases I try to use the smallest implant that will restore the degree of fullness in the upper poles that the patient wants (unless she specifically wants to be significantly larger, knowing the risk of stretching out).

the mastopexy augmentation operation increases breast volume while decreasing the volume the skin envelope can hold. When doing this operation balancing volume of the implant with maintaining blood supply to the nipple and skin is critical. If you are pleased with the shape and appearance of the breast at 4 days then you will most likely love them in 3 months. The implant position and tension of the skin will change gradually over the next 3-6 months. Allow your body the time to heal and enjoy the significant improvement you have achieved.
If you still feel they are too small at 6 months, it is a very simple procedure to place a larger implant. My suspicion is you will be very pleased with the 450 cc implant.
Good luck.

Hello!; Breast Implants and their interaction with the skin and muscle tend to change over time.  This leads to a softening of the skin , allowing the implants to lower. This can change their original view from full to elongated. But not much.  Hope this helps!Dr J 

It's a great question. As your implants settle the implant volume will shift from the top to the bottom of your breasts. Having more volume at the bottom of your breasts gives you a more natural look and will make your breasts appear larger and slightly closer together. Waiting for implants to settle fully can be frustrating, but make sure you continue to follow your surgeon's instructions carefully. Congratulations on your procedure!

Breast implants can definitely make the breasts look larger as they "drop and fluff' which basically means the skin relaxes and allows the implants to settle. 

Thanks for your question.Generally, the implant will look smaller as the implant drops and swelling subsides.  You may need a larger size, but please wait a sufficient amount of time to decide on this.  Ideally you would wait 3-4 months before making a final determination on changing the size of your breasts.Aloha,Shim Ching, MD

Thanks for the great question. It is hard to say without photos or an exam but 450cc's after a lift is pretty aggressive.  I don't think going any bigger would be a better option.  If your breast were prone to sag without implants they are only more likely to do so again with large heavy implants exerting pressure on your breast.  Also size and preference changes depending on how old you are.  I find that my younger patients are typically looking for larger breasts while women in their 40's are not trying to look too big.  So it is important to keep this in mind when choosing your implants.  I feel tat the goal is something you are going to be happy with for a long time, not just the next few years.I hope this helps :)

Only four days out, it is very hard to say anything about the final outcome. Breast implants tend to start dropping into place after 3 to 4 weeks. They usually will get to their final position in 6 to 12 months. One will drop faster than the other, also the shape may go through changes. Please follow your Board Certified Plastic Surgeon's post op instructions. For example; we like message, but some surgeons will have you wait, or do it in a specific manner. Please also let them know your thoughts and concerns.