Breast Augmentation, Does my Dropping Progression Seem Normal? (photo)

Mentor 500cc silic, mod prof, under muscle. 1.6m tall, 55kg, pre op 34/75b. transax. Hi just wanted to know if i will have more drop, i seem to still have a lot of upper pole fullness. I have been wearing a strap & massaging since 5weeks post op. I am now 2months 1 week post op.Worried my lower pocket will scar or close before implant gets a chance to drop further. Is there anyway i can manipulate them to drop into the pocket sooner? will applying hard downward pressure help?...thank you

Doctor Answers 22

Your implants may not drop much further.

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At 9 weeks post-op, you still have much scar maturation to occur, and some degree of further dropping is likely. But how much? and will it be "enough?"

Thanks for including detailed photos: your second one tells me something that other have not commented on--there is significant peripheral bruising present on both breasts, indicative of some degree of bleeding (more than should be anticipated, IMHO). This blood can lead to increased capsular contracture (thick tough scar around your implants) that impedes implant dropping, and may in fact lead to an increased risk of capsular contracture.

All the elastic bands and downward exercises in the world cannot remove a thick unyielding capsule, and your implants will be unable to drop much if this undesirably thick scar capsule acts as a (too high) supportive internal sling.

Unfortunately, inframammary crease malposition is more common with transaxillary incisions, and yours is further complicated by the unfortunate bleeding that has contributed to your inability to drop as your surgeon and you anticipated. This will likely require revisionary surgery, but I would certainly wait a full 6 months to determine just how much and how long changes might still occur. I'm not optimistic and am sorry to have to tell you that. Keep in touch with your surgeon; this is nobody's "fault" since bleeding can occur in any number of settings for any number of reasons. Best wishes! Dr. Tholen

Elevated Implants

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The period of time immediately following breast augmentation surgery is characterized by rapid change. During this period, swelling, muscle spasm and the healing process all contribute to changes in the appearance of a woman's breasts.

In some cases, swelling and muscle spasm can displace the breast implants in a superior direction when implants are placed beneath the muscle. In other cases, superior implant displacement may be due to inadequate dissection of the muscle insertions of the inferior portion of the breast pocket. This is far more likely when a trans-axillary breast augmentation approach is utilized.

With time, assuming adequate pocket dissection, these implants might return to a more normal position. Sometimes, the use of a superior bandeau and massage may facilitate this process, but again this is less likely when a trans-axillary approach has been utilized. It may take 3 to 6 months for these implants to drop into a normal position.

If no progress has occurred after six months, revisional surgery will be necessary. This would involve recreating the lower portions of the breast pocket through an infra-mammary approach.

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.

How Long For Breast Implants To Drop After Transaxillary Augmentation

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Thank you for your question. I share your concern that your Implants are not dropping as fast as I would like.

It is true large implants through a trans axillary incision take longer so I would continue pole wrap and downward massage until 6 months.

If they are still this high then revision will be necessary if you want lower pole fullness.

This is a simple release procedure but will have to be done through an Infra mammary Crease incision for accuracy and the best result. Don't worry in time the scars will not be visible on frontal view.

I am concerned

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Good afternoon!

I am concerned that looking at your photos being two months postop that while your implants may continue to drop, i do not personally think they are going to drop enough to give you the look you are looking for.

I would have a  frank discussion with your PS about this issue.

I hope this helps  

Will Implants Drop Further?

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At 9 weeks, it's too early to judge, and implants haven't settled in fully.  You can use a superior band and downward massage with careful instruction. Give it at least 6 months.  

I am concerned that 500 cc implants are a bit big for your chest wall and this is contributing to superior fullness. Time will tell. 

Wait it out for a couple more months

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It takes about 4 months for implants to drop, so you still have a bit of time. You could try wearing a bandeau on the top of your breasts to help them along, but ask your surgeon about it first.

Breast Enhancement Surgery

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One thing that is consistant with implants inserted through the axilla is that they tend to ride high because of the incomplete release of the muscle, this may be true in this situation 

Ar e the implants dropping fast enough? Trans -ax placement.

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Your implants are a bit high for being 2 months postoperative.  Trans-axillary placement of breast implants do take longer to descend.  Pushing hard on your implants will not help you.  Continue to have an open dialogue with your plastic surgeon regarding your concerns.  Every plastic surgeon has a protocol that is slightly different from another plastic surgeon.  You trusted your plastic surgeon to do the surgery, now trust them to take care of you afterwards.

Implants settling after augmentation

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Hi Sassouri. Based on your photos, it seems that your implants are still settling. Sometimes this can take longer than 2 months, so I would continue to observe them and continue your follow up with you plastic surgeon.

I hope that helps and wish you the best.

Breast Augmentation and Dropping with Massage

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   Larger implants take longer to drop, particularly in smaller women.   Massage can help, but larger implants may take 3 to 6 months to drop to their final levels.  Kenneth Hughes, MD breast augmentation Los Angeles, CA

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.