Frankenboobs: are my implants sitting too high? (Photo)

Question

I’m 18 days post op. My implants are so high I can’t even wear a cute top. I stay covered in large shirts or sweaters. I went for my post op appointment last week and doctor seemed very concerned and immediately gave me a strap/band to help push them down. Do muscle relaxers at bedtime help ?

John LoMonaco, MD, FACS · Answer

You will have some settling of the implant, and this may take many weeks.  A compression band, massage, tummy time, and other things recommended by your doctor may help.  The ultimate question is whether the implants will settle completely. This will all depend on how well your surgeon matched your implant to your breast tissues. 
If the implant is too big, the implant will stay too high and the nipple too low.

Gerald Minniti, MD, FACS · Answer

Hello,Although with time your implants will drop some, it is likely that you will always have some degree of overfilled upper poles and downward pointing nipples. The reason is your anatomic capacity could not handle this size implant, something your surgeon didn't either bother to determine or discuss with you. You will need to wait at least 6 months, but you should get a second opinions from a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

At 18 days you are about 13 percent settled, shaped, softened, dropped and fluffed. "Drop and fluff" refers to the fact that as the skin stretches and the muscles relax, the implants move down and out slowly – about 1 percent a day. It’ll be about six weeks before they even begin to settle down, but they’ll be close to 80 percent settled at three months. Watching their progress is like watching your hair grow. You don’t see a difference in your hair growth daily, but all of a sudden you need a haircut. 
Be patient after surgery. Give yourself a few months before making a judgment about your surgical results. You won't know the outcome until then. You should express your concerns to your surgeon. Revision surgery should never be considered before 6 months, when you are closer to 90 percent settled.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author
Phila., Pa.

Daniel Barrett, MD · Answer

Dear Angiecali,dropping of implants is part of the healing process and this occurs after the tissues surrounding the implants slowly relax, allowing the implants to settle into their final position. It can take about four to six months for the implant to drop down to their final position.I understand that you are worried about your implants are not dropping as expected. However, you are still in the early phase of the recovery period. Please do allow some time for the healing process to occur. If after six months, you are not satisfied with the appearance of your breast, you can visit your plastic surgeon and discuss your concerns.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Curtis Wong, MD · Answer

and your surgeon has implemented the strap protocol to help get them down.  If you have smooth round implants, this should work nicely.  If you have textured anatomic implants, its more uncertain as to just how much setting you can get.  Your surgeon should want the best outcome for you so follow instructions and hopefully they will get to where you want your upper poles to be.

Daniel Brown, MD, FACS · Answer

Hello and thanks for your photos and questions.  Unfortunately, you will almost certainly require a revision.  The implants placed are far too large for the pocket that was created -  you will not get the result your desire from just wearing a band or taking muscle relaxers.I would encourage you to schedule a consultation and discuss your breast augmentation revision treatment options with a Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), who is a member of the American Society of Plastic Surgery (ASPS), and also a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS) demonstrating their commitment to cosmetic surgery and excellence in surgery.  Assure that they have multiple before and after photos of results that you like so that you can have an informed discussion about your breast enhancement/correction and possible results.
Best wishes!
Daniel Brown, MD, FACS    
Diplomate, American Board of Plastic Surgeons    
Member American Society of Aesthetic Plastic Surgeons    
Member American Society of Plastic Surgeons     
Real Self Top 500

Donald W. Hause, MD · Answer

Thank you for your question. It is difficult to say anything from a single picture but there are several reasons this could be occurring and it is likely this will continue to get better over the next few weeks. If you started out with some sagginess of your breasts before augmentation, your nipples may stay low with the eventual result. Some surgeons will place a larger implant in an attempt to avoid doing a breast lift but that has its own issues down the road. Give it some time and see how it goes. If it persists, visit your surgeon and consider getting a second opinion from an experienced Board Certified Plastic Surgeon who does a lot of revisions. However, you are far from that at this point. Wear the band and begin massaging the breasts in a few weeks. The final result may not be present for a few months and you may be pleasantly surprised at how good they look.

Tim Sayed, MD, MBA, FACS · Answer

At less than 3 weeks, you are early in recovery. Strapping with an ACE bandage or band dressing is important at this phase to try to encourage descent of the implants. It is possible this is just early postop muscle spasm and swelling, and implants do "drop and fluff" in most patients. If they do not drop over several months, it may be necessary to reposition the pocket by releasing the capsule into the lower portion of the breast. Give it time and keep in close communication with your surgeon on followup.

David A. Sieber, MD, FACS · Answer

It takes some time for the implants to settle. Things that take the process even long are over sized implants (which it looks like you might have) and textured implants. It can take 3-6 months for implants to completely settle so be patient during this process. If your surgeon can you a band to wear or massages to perform, you can try these during this time to see if it helps move things along.Best,~Dr. Sieber

Arian Mowlavi, MD, FACS (license on probation) · Answer

Implants that were chosen were too large for your breast; the first thing to remember is that your nipple to inframammary crease distance must match the radius of the chosen implant otherwise the implant will not fit properly and not amount of strapping is going to help. What you have is what we call the "eggplant" shaped breast that is caused by an implant that is too large for your breasts. You have two options to correct your breast shape: 1)choose a smaller implant; 2)get a mini lift of your nipples upto the center of your implants.

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