Why, yes, they do indeed look a little weird right now! However, this is both normal, and temporary!You still have steri-strips on in one of your photos, and clearly have swelling of your nipple/areola complexes in others. Slight bruising also indicates that you are quite early in the healing, softening, and settling process.Here are a few things to know: 1. Your pre-op photos show attractive breasts with normal shape. Unless incisions are made to alter the shape of your breasts (none for you), enlarging them with implants will not change the basic shape unless textured, shaped implants are used (you do not have these). Implants fill the skin brassiere you already have, so as they settle your shape is going to be a larger version of whatever you brought to the party. 2. Implants that are placed properly look at bit funky at first, because they start out a bit higher than ideal, allowing gravity, healing, tissue stretch, and scar maturation and softening to occur. Gravity works pretty much 100% of the time, and on 100% of patients. The direction of gravity's force is down for that same percentage of patients, so it appears as if your surgeon thoughtfully took this into account, rather than making things "perfectly positioned" right now, and hoping a bra is antigravity and that you will not bottom out too much. Otherwise the office lobby is full of women 6-12 months post-op whose implants are too low (bottomed out or double bubble) and need re-operation to raise their creases. Not good. Not happy. Good for marketing if you are the kind of surgeon who ignores unhappy patients because they look good initially, but not long-term. 3. Cleavage is obtained by means of a good push-up bra, not by implant placement. Anatomy of normal chests make breasts point slightly to the side (not straight ahead, unless you have a pectus excavatum). Of course you have to have enough breast volume to push up--you now do! 4. Veins are normal, just like those on the back of your hand. They will diminish in their visibility as healing and inflammation diminish. PS: No one is looking at the veins when your breasts look this great! And they will look even better as time goes by, gravity does its thing, and tissues stretch a bit. 5. That "torpedo" shape will go away as the implants and your own breast tissues are properly aligned with your nipples. Your "puffy nipples" will also diminish as swelling does the same thing.Voila! Pretty breasts! Complete healing takes 6-12 months, so I hope you and your surgeon get together periodically during that year to assess things like elastic bandeau use, supportive bras rather than push-up bras (OK for special occasions, but not as daily wear until healing is complete, eve if you like that look for every day!), avoidance of ultraviolet on your scars, silicone scar pad use, and use of antibiotics for dental work or any invasive procedure that could cause a bacteremia. I know I'm in a minority, but I believe implants should be treated just like heart valves and knee implants. Antibiotic prophylaxis is well documented in the cardiac and orthopedic literature. It is beginning to be documented in the plastics literature as well. Bacteremias are well documented as occurring with most dental work, including cleaning. If a minor breast trauma (slip and fall hitting the bannister, volleyball spike, elbow during the night, or head butt from a child in your lap) happens to coincide with dental work releasing bacteria into your bloodstream, and then via the minor injury into the space around an implant, a biofilm could develop, and a capsular contracture result. I personally have seen isolated, single-side, late CC in 7 cases over 30 years of my career. In one case, 19 years after I placed implants that remained soft and mobile for all those years, 1 week after dental work one breast got very hard (Baker 4) and painful. The other was soft. When I asked her about the antibiotics I recommended, she said her dentist told her she didn't "need" antibiotics as he'd never heard of them being used for breast implants, so she stopped them 8 years ago. I wonder if the dentist would appreciate it if I said flossing wasn't necessary.We wear seatbelts every time we drive a car . . . why not a dose of antibiotic before every dental visit?So there's a long answer to a short question. Patience, fair maiden, you will look fabulous as time goes by. but watching your progress is like watching grass grow--can't see it even if you try to do so ever so carefully. But go on vacation for a week and when you get back the darn lawn needs mowing. Your breast progress is much slower than grass growing, so take a selfie every month (arms down in the bathroom mirror) and see your progress. It's that slow, which is why you should see your surgeon every few months until your healing is complete in 6-12 months. Best wishes! Dr. Tholen
