How Long Does It Take Implants to Look "Normal" After Reconstruction Surgery?

The size of the final implant is determined by the amount of volume placed in the implant during the expansion procedure. Tissue expanders project more than silicone gel implants, and that is why your surgeon was able to place 650 cc implants after using 600 cc expanders. Also, the width of your chest wall limits the size of the implant, as one must be careful to not place too wide an implant in the pocket that it extends into your axilla, or underarm.

It takes about 3 to 6 months before most women see the final size and appearance of their reconstructed breasts, so be patient. It is wise to wear a good, supportive bra, especially when exercising, to help keep the implants in a good position. Also, massage the breast to keep it soft and pliable. Taking an antihistamine, such as an over-the-counter anti-allergy medicine, may help decrease your risk of capsular contracture. I also recommend avoiding isolated pectoralis muscle strengthening exercises, which can result in visible contracture of the muscle with activity if you are very thin. Plank exercises associated with yoga and push-ups are OK.

With a breast reconstruction like yours, it may take anywhere between one and three months for the implants to settle or take the shape/look that they will always have. After tissue expanders are exchanged for implants, the soft tissues covering the implants will conform to the new implant shape rather than the previous expander shape. Sometimes there may be little change after surgery, but more often this process takes several weeks to be completed. If you were expanded to 600cc and 650cc implants were placed, the implant pocket is probably fairly tight around the implant and there may not be much change over time. With 650cc, you should actually have a C cup volume, but because the implants are not the natural breast shape, they may not completely fill out a bra cup. To help the implants settle and to help keep the breasts as soft and natural looking as possible, some surgeons recommend some form of implant massage. You should check with your doctor to see if this is recommended in your case and follow whatever he/she recommends.

Thanks for your question. In your situation where your sizer was up to 600cc and the new implant is 650cc I would expect your implants to start to settle around 6 weeks. Start. It may take up to 6 months. If you are interested in larger implants following the healing process you should be able to go as large as you want, pending the implant company makes the size you want.

Jess830409, that's a great question.  Undergoing breast reconstruction after a mastectomy is a very different process when comparing it to cosmetic breast surgery.  The expansion phase puts a lot of stress on the skin after the removal of breast tissue and affects the ability of the breast to heal.  During the removal of the tissue expander and insertion of the final breast implant, most surgeons will do a bit of 'fine tuning' to get the tissue into its optimal position which causes further trauma to the area that will require healing.  Overall, you likely won't see your final result for 3-6 months but in the meantime, be patient with your breasts and provide them with good support, eat a healthy diet, and don't sleep on your stomach; this will allow the breasts to heal at their normal pace. 

Most women will be close to their final outcome after 3 months. In my experience, the bigger the implant the longer it takes for ultimate healing, #DropAndFluff , especially if you have toned pectoralis muscles and the implants are submuscular.

This is a great question and the answer depends on a number of factors.
Implant based reconstruction can either be tissue expander at the time of mastectomy followed by implant placement at a second operation, or “direct-to-implant” placement at the time of mastectomy. While direct-to-implant is convenient, generally implant sizes are smaller than what could be achieved the tissue expanders although this depends on your preoperative breast measurements.
With regards to surgical swelling, most of it will be gone by 6 weeks but the last 5-10% will hang around for another 6 weeks. That’s why most surgeons will say to wait at least 3 months for what should be closer to your final result in terms of overall shape. For reconstruction, the needs of the cancer treatment dictate the type of mastectomy, lymph node excision, and radiation, all of which have an impact on the reconstruction. I advise patients to give it at least 3 months to heal, and to expect to have some contour irregularities and scar revisions that may need to be addressed at a secondary revision operation with fat grafting, etc. Finally, nipple/areola reconstruction can be performed as the final phase of reconstruction at least 6 months after the last operation.
Of course, the results will continue to change slowly over time (years), as the forces of gravity continue to act on all parts of your body, including the reconstructed breasts. The larger the breast implants, the more force on the tissues and the more rapid the rate of descent/change. In practicality, this may mean you notice that the implants have dropped to a less desirable position at 5-10 years instead of lasting 10-15 years in a good position. For patients frustrated with or having issues with breast implants, revision of implants or replacement with your own tissue both may be options.
Breast reconstruction is an art and a science and requires a skilled plastic surgeon experienced in breast reconstruction. It is important to seek out a board certified plastic surgeon to meet with prior to your reconstruction procedure. It is also too important to note that there are implant-based and your-own-tissue-based options for breast reconstruction. You may also want to make sure that your plastic surgeon is skilled in all methods of breast reconstruction, both implants and tissue, so that you have all options available to you and you can select what you think is best for you and your unique situation.

I have noticed in my reconstructive patients that it takes a good 3-6 months for the implants to settle into place and for the skin to reshape after having expanders in place, which obviously have a different footprint than the implants do. Seeing my patients even 1-5 years out, there is continued settling and softening of the implants. If you are not happy with your size right now, just wait and upsizing can likely be done at a later time. Going too large at the time of the expander exchange can put you at risk of wound healing problems, which are not ideal given you have made it that far in the process already. 

Hello and thanks for posting your question.The second stage operation to exchange tissue expanders and place permanent silicone prostheses is often seen as an instantaneous delivery to a final result. Regardless of this perception by patients, there is still a recovery period and swelling that come along with this operation. Depending on what was done by your plastic surgeon (just implant exchange or any pocket modifications or fat grafting are examples) to help frame the expectations to the timing necessary to see final results. I would recommend that you discuss your questions with your  plastic surgeon frankly so that you have an idea of what to expect.Wishing you the best!

It generally takes about three months for the post-surgical swelling to resolve and for the implants to settle with gravity. So it is important to be patient and give your body time to heal before considering the final result. 

It can take many months for implants to settle and take the shape/look that they will ultimately be. In general, they tend to drop in placement (due to gravity) and shrink in size (due to decreased swelling and sometimes capsular contracture). It is unlikely that the implants will grow in size. After a few months, however, if you still feel that your implants are too small, you can have a discussion with your plastic surgeon about changing the size to better suit your body.