Is leaving muscle at the bottom of an implant normal with internal stitching? (Photos)

First BA, 24 yrs no kids. 10 weeks post op. 450cc. I am not sure if implants are behind/Infront of muscle but I feel like I can make out the real breast tissue Infront of the implant. Muscle was left under the implant to prevent sagging & side pockets w/internal stitching (that I can feel perfectly when I touch). The left breast is taking a odd cone saggy shape & the nipples continue to set too low! Still somewhat numb & tender. I have been massaging since 3wks PO as instituted. Will they drop more or should I request a revision? Unhappy

Doctor Answers 5

Breasts dropping

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Breast implants initially after surgery when placed in a submuscular position often give superior fullness that corrects itself with time, the "fluff and drop" phenomena. In reality the pectoralis major muscle takes a while to adjust its size to accommodate the implant as well as occasional muscle spasm which keeps the implant projection higher than its final resting shape. Additional variables include:laxity of skin, size difference during prior pregnancies, position of implant,size of muscle, and size of implant.
As the muscle relaxes the projection of the implant often increases and the breast shape improves. Massage and use of a superior placed elastic strap can often make this process go faster.

Is leaving muscle at the bottom of an implant normal with internal stitching?

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It appears your implants are still sitting high. They will descend with time. Please follow up with your surgeon. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Is leaving muscle at the bottom of an implant normal with internal stitching?

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Thank you for sharing your question and series of photographs.  I am sorry that your current results are distressing, but you are very early in your recovery process.  You breast skin and underlying muscle are swollen and tight as a result of surgery, causing your implants to be elevated on your chest and appear slightly flattened.  This will resolve with time to leave you with a more natural breast appearance - rounded and full lower portion of your breast.  Hang in there, I know waiting is difficulty, as your final results may not be seen for up to 6 months after surgery. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Implants not dropping

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Generally speaking, especially early in the post-operative phase of healing, it is not uncommon to have one or both implants appear to be high up by the clavicle. Although the “pocket” may be made correctly, the implant may not have access to the bottom for several reasons. If the overlying muscle or skin is tight, this will move the implant to the path of least resistance which is up and towards the underarm where there is little or no pressure. As the pressure relaxes, the implant will drop down to the bottom. Smooth implants, because their surface is slippery, may move faster downward than a textured implant with its rough surface. Because these variables mentioned above can be different for each side, it's not uncommon that one side will drop faster to the bottom of the pocket than the other. Similarly, sometimes one breast will swell more than the other or be more painful than the other early in the postoperative phase. After the first month or two, usually things will even out. It wouldn't be, in my practice, until four months or so has passed that I would entertain going back to the operating room to “touch up” the location of the breast implant in the pocket. Sometimes specialized bras or straps as well as massage and stretching protocols may be helpful in allowing this process to happen more quickly. Each plastic surgeon will have different thoughts on what the best protocol is for the patient. Your operating plastic surgeon will be your best resource to have this information passed on to you. I recommend that you faithfully follow up and follow the instructions of your chosen plastic surgeon. Congratulations on your surgery, and good luck on an uneventful recovery.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Is leaving muscle at the bottom of an implant normal with internal stitching?

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Your right breast may continue to drop but I am concerned that you may need a lift on the left lower breast. See your surgeon for an exam. Not sure what the internal stitching was done for. See below for more on lift:

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.