**6 Days Post Op** Breast Augmentation**implant Placement High and Unnatural -- HELP?

I posted pre and post op pictures Armpit incision with 380 high profile saline implants I'm 5'9 135 pounds My boobs look terrible.. Is it normal to have this shape after 6 days? Please help When should I expect positive results?

Doctor Answers 14

Implant Placement High and Unnatural

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It is pretty much the rule that under the muscle implants are high riding in the early period after surgery.

Submuscular implants are sitting as if they are at the bottom of an envelope. The breast fold, like the bottom of the envelope keep the implants from descending. At the upper pole is a large space under the muscle and above the ribs, and that space goes up to the clavicle (collar bone). Typically the implant position looks fine at surgery. As the patient awakens, the relaxed pectoralis muscle contracts, pushing on the implant. This displaces the silicone (or saline) which bulges into the upper pole, the only direction with room to expand. The lower pole of the breast may seem to empty out. But the implant itself doesn't actually move. As the muscle relaxes over several months, the upper pole no longer bulges , the lower pole of the breast fills out, and the implant position looks like it did in surgery.


Best wishes.

Seattle Plastic Surgeon

Breast augmentation with placement too high and unnatural

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Breast implants will "settle" to some degree and too much fullness in the top of the breast may be very normal in the immediate stages post operatively. However, we all have seen this as a permanent result in some before and after photos.
A common error that leads to an unnatural appearance after breast augmentation, even with implants of an ideal size, is inadequate lower pole dissection and/or inadequate release of the pectoralis major origin just above the inframammary fold. As a result the implants sit too high and appear excessively full in the upper poles (the area above the nipple-areola complex), while the lower poles - which should be the fullest area of the breast - are underfilled. Inadequate muscle release may also result in bizarre-appearing breast implant animation when the pec major muscle contracts. In some cases this may result in one or both of their implants jumping up literally to the level of a patient's collarbones - an alarmingly unnatural look, and one that is totally avoidable 


A shaped form stable breast implant can give the patient the lowest risk of fold and ripples in the lower pole, the lowest risk of a visible transition between natural breast tissue and implant  (sometime refereed to as a double bubble) and the lowest risk of breast implant malposition with the breasts bottoming out. I think there is a performance difference between form stable breast implants. Consult with plastic surgeon who have experience and expertise perfuming this particular procedure. 

In many breast augmentation patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition, inadequate release of the inferior origin of the pectoralis major will allow the muscle to hold the implant in too high a position, and may even cause the implant to displace upwards (as high as the collar bone in some patients) when the muscle contracts. Patients with this problem require reoperation to release the inferior origin of the pec major and/or the inframammary fold. 

Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance, and one that requires surgical correction: repair of the inframammary fold(s).  

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Early high ridding implants

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It is not unusual for the implants to ride high after a submuscular breast augmentation.  The good news is time, weight and gravity are on you side.  As long as the pocket was dissected properly the implants will drop.  Massage will help to push the implant down.  If you are having muscle spasm a muscle relaxant may be beneficial. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

High implants a week post op - don't despair

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as they will settle.  Your doctor should be advising you on strategies to help get them to come down.  And as I am not an advocate of the armpit approach, I cannot be objective in your case but know implants will settle.  Your doctor wants you to have the best results possible so stay the course.  Revisions can always make things better and its hoped you won't need any.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Reason for concern

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If the pocket for the implant is not made low enough at surgery, it is unlikely that the implant will ever fall to the correct positon with the passage of time. At surgery, it is important to elevate the back of the operating table as much as possible to see whether the shape of the breast is satisfactory with the patient nearly sitting up. Only by doing this, can the surgery determine whether the pocket for the implant is low enough.

If the pocket for the implant was made low enough, but the implant has shifted upward after the surgery was finished, the implant can nearly always be made to shift down to the bottom of the pocket made for it. I prefer to actively have my patients to push their implants down with their hands, and only have them use the elastic strap at night.

If the pockets for your implants were not made low enough at surgery, it is unlikely they will ever fall to a satisfactory position. You should see your plastic surgeon as soon as posssible.

John J. Bandeian, MD
Bristol Plastic Surgeon

Too early to panic

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At this point, it is difficult to tell if a problem exists.  Many patients with first time breast implant surgery will have a lot of swelling in the upper part of the breast until the tighter, lower part stretches.  It is true that implants placed through the armpit incision can end up riding too high, but it is very early after your surgery and may be impossible to tell at this point.  Talk to your surgeon and discuss your concerns.  Try to be patient.  Best of luck.

Michael S. Hopkins, MD (retired)
Albuquerque Plastic Surgeon

6 Days Post Op

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Six day post-op is much too early to panic! At this point you should be concentrating on healing.  Once you start the exercises, everything will look much better. It takes time for the swelling to decrease and for the implants to settle down. The best thing to do is discuss your concerns with your surgeon.

James E. Murphy, MD, FACS
Reno Plastic Surgeon
5.0 out of 5 stars 32 reviews

**6 Days Post Op** Breast Augmentation**implant Placement High and Unnatural -- HELP?

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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!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Transaxillary BAM 6 days post op

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At 6 days post-op, it's really too soon to worry about shape.  I'm not a big fan of the transaxillary incision because of this exact reason.  Make sure you talk with your surgeon and go over your concerns, perhaps ask about a breast band and massaging.  Every patient and situation is different but breasts can change shape anywhere between 3-6 months so try to be patient and re-evaluate then with your surgeon.  ac

Angela Champion, MD
Newport Beach Plastic Surgeon

Implant in the breast shape may take several weeks or even months to finalize.

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The artificially supported volume of the breast implants should change as swelling subsides. This may take a number of months however.

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.