Can You Explain the Upper Pole Fullness/swelling After Breast Augmentation Surgery? (photo)

The period of time immediately following breast augmentation
surgery is characterized by rapid change.During this dynamic phase of healing, swelling, muscle spasm and the
healing process itself all contribute to changes in the appearance of a woman’s
breasts.In some
cases, superior implant malposition can result from swelling and muscle spasm
when implants are placed beneath the pectoralis muscle.Based on your pictures, I believe this is a
distinct possibility.In other cases,
superior implant displacement may be due to inadequate dissection of the muscle
insertions of the inferior portion of the breast pocket. With
time, assuming adequate pocket dissection, these implants will usually drop
into a more normal position.Sometimes,
the use of a bandeau superiorly and massage may facilitate this process.It may take 3 to 6 months for these implants
to drop into a normal position.If no
progress has occurred by then, revisional surgery may be necessary.This would involve recreating the lower
portions of the breast pocket. It’s
important to have good communication with your plastic surgeon.Make sure he is aware of your concerns.He is familiar with the specifics of your
surgery and will be able to give you appropriate direction.

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. Hope that this helps! Best wishes!

When implants are first inserted, they sit high up because your tissues are tight and gravity hasn't taken effect. Over time, natural tissue expansion occurs to allow the implants to fall into place. By this time, your breasts will have taken on a more natural contour, where the lower breasts become softer and rounder. Please wait at least four months for this to happen.

Upper pole fullness after breast augmentation may be due to several factors. Submuscular implant placement results in significant though temporary swelling of the superior aspect of the muscle. Implants placed under the muscle tends to rise in the pocket in the early post-operative period due to the pumping action of the muscle squeezing the implant up along the chest wall. It's important to wear a restrictive binder above the breasts during this early period and to perform massage to push the implants down in their surgical pockets. This process may take weeks, on many occasions one or both submuscular implants might not "drop" and revision surgery may be indicated to reinstate the implants.

Thanks for the excellent pictures. How long ago was your procedure, I do not think I saw that in your question.  Your implants are riding high.  If it is within the first several weeks, they can continue to drop on their own and you can speak to your surgeon about massage or a device called a bandeau to help them fall.  If you are several months out, they may not fall much further.  Please speak to your surgeon.

Thank you for the question and photos.  Swelling after the surgery is not uncommon.  Knowing your operation date would have been useful.  It should take your breasts around 4-6 months to fully heal and settle so best to give it time.  Best of luck. Dr. Michael Omidi.









An
in-person exam with a board-certified plastic surgeon is the best way to assess
your needs and provide true medical advice.

If you had your surgery under general anesthesia the chest wall muscles were paralyzed during the procedure. Very likely your surgeon felt that you had good positioning of your implants under the muscle. As you recover from anesthesia however and continue through your immediate postoperative recovery the muscles often contract and tighten pushing the implants in the direction of least resistance which is upwards. This results in a higher location of the implants and the appearance of fullness in the upper portion of the breast. Very commonly as the muscles relax and the lower part of the breast stretches the fullness settles down to the bottom of the breast leaving a satisfactory outcome. It would be helpful for you to perform massage exercises daily pushing the implants toward the bottom of the breast. If you are within 2 weeks of your operation it would be helpful to wear a compression band at the top of your breasts to help promote downward pressure. If you're condition persists after 6 months it's unlikely you will notice much change and may require revisional surgery. Good luck

Thank you for the question and pictures.

Although some of the “bulgy” look at the top of the breasts  after breast augmentation may be related to swelling,  most of the is related to the location of the breast implants. The breast implants are “riding high” because the pectoralis muscle is contracting and maintaining the breast implants higher on the chest wall.

I see this phenomenon routinely after breast augmentation surgery;  it may take several months (and even up to one year) for the breast implants to fully settle (" drop and fluff”). Although many patients may not believe it, the breasts often appeared larger as the implants settle.  I think that “downward” massage  may be helpful in expediting this process.

I hope this helps.

Upper pole fullness after breast augmentation is common after submuscular augmentation especially. It is my belief that the muscle, having been elevated off of the ribs has a period of time where it goes into spasm, forcing the implant up. Combined with perioperative swelling, it is typical for the implants to ride high for approximately 2 weeks postoperatively and then typically drop one night while the patient is sleeping. I believe the muscle simply relaxes and stops having spasm. If the pocket was well dissected in the lower part of the breast the implant  usually falls to where it belongs  This is a progressive phenomenon over approximately 2 months. Relatively final results are seen at that point in time. We use an indwelling pain pump which is placed through the skin and lies under the muscle. With this IV catheter functioning like a soaker hose with a four-day continuous flow of local anesthesia, I now see this quite rarely. The muscle doesn't spasm as much in the presence of the local anesthesia  I do use a bandeau bra early postoperatively to  help  insure that the implants stay low.

Thanks for the photos posted. Reasons for early upper pole fullness are: Muscle spasm or contraction not allowing dropping of the implant, swelling, seroma/hematoma, poorly dissected inferior pocket. If over 2 months post op than I would be concerned for poor inferior dissection. Only treatment is revisional surgery.