Too much fullness up top?

My implants are so extremely full on the TOP near my chin and there's barely any towards the bottom. Is that normal? I'm looking at other implants of women who are one day, two day post op and they have fullness all around.

Doctor Answers 5

High Positioned Implants

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Most implants will appear to be high early after surgery.  As the tissues relax (skin, muscle, breast) and as the swelling resolves, the implants will settle into the proper position.  The speed at which this happens varies from patient to patient.  Sometimes it only takes a few days while others may take a few months.  

Sometimes patients will be given a superior compression band to help speed the descent of the implants.  I will usually start this at around the 2 week mark if the implants are not settling as quickly as expected.

I recommend close follow-up with your plastic surgeon. He/She will be the best to determine if anything is out of the ordinary.

Honolulu Plastic Surgeon
5.0 out of 5 stars 120 reviews

My Implants Appear Too High 2 Days After Surgery

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Implants basically fall into two categories - those that are on top the muscle and those that are below.

Implants on top the muscle have much less pressure on them even if one has tight skin, and therefore over time, may actually move in a downward direction.  Because of that, the drop and fluff concept of post implant migration can actually mean the implants can drop in an open pocket. 

Implants below the muscle are tightly held by both muscle and skin, and here, the concept of drop and fluff, in my opinion, does not refer to the actual implant dropping (the coefficient of friction is much too great), therefore, when one talks of the drop and fluff phenomenon, one is referring to the fluid in the implant descending from a higher position to a lower position as the tissue stretches out.  

Hence, whether implants are above or below the muscle, in the first few days or weeks after surgery, they appear to be riding too high until either the implant and/or the fluid or both begin to drop and fluff as the skin and muscle relax. 

Things change with the appearance of breasts and breast implants over time and usually for the better.  I recommend you discuss your concerns with your Board Certified plastic surgeon. 

Too much fullness up top?

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Thank you for your question. Your plastic surgeon will always be your best resource when it comes to an accurate assessment of your situation, advice, predictions, and/or meaningful reassurance.
Generally speaking, breast implants will "drop" into the pocket that was created during surgery and massaging the implants downward may assist in the dropping of the implants after surgery (for those patients who want to help with the settling of the implants). The rate of breast implant "settling" may depend on factors such as size of breast implant pocket dissected, tightness of the overlying skin/muscle layers, and size of breast implant utilized.
Normally, it takes about 3-6 months (for some patients longer) to see the final result. It is very common for one side to settle faster than the other.
Again, best to follow your plastic surgeon for more specifics. Best wishes for an outcome that you will be pleased with long-term.

High riding implants

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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

Too much fullness up top?

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Thank you for your question.  It would be helpful to have pictures to fully address your concerns, but two days post-op you are most certainly still experiencing swelling, which is normal.  In addition, it can take some time for the implants to settle into the pocket.  Try to be patient and not compare your results with others, because each patient is unique with differences in anatomy, breast size and implant size and type that can determine how healing progresses. If you continue to have concerns, please talk to your plastic surgeon for reassurance that the healing process is going as expected.  Best of luck to you.  

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 72 reviews

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.