9 months post breast augmentation, concerned about nipple asymmetry - Can drop / fluff happen this late into recovery? (photos)

The breast implant position will not change appreciably after 9 months postoperatively. It is difficult to assess your implant position because of the differences in arm positions. The considerations for implant malposition include: 1) pre-existing asymmetry, 2) implant did not drop, 3) the other side dropped too much, and/or 4) capsular contracture. I would recommend visiting your plastic surgeon with your concerns.

I would review your preoperative pictures and your situation with your plastic surgeon. Asymmetry is common prior to surgery however you may have some "failure to drop" or capsular contracture. I like when implants center on the nipple, however that's not always possible. Best Wishes!!

Dear Loving579826,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for sharing your question and photographs. After 9 months only a surgical revision is going to be able to improve upon your current results in the interest of achieving improved symmetry. Talk to your surgeon.

Usually at 9 months out the implants are where they are going to be unless your skin quality changes(ie weight loss/gain, pregnancy). Its hard to see the asymmetry with the arms up. I would advise seeing your plastic surgeon and comparing your before and afters to see what can be done to achieve your ideal result!

You probably have a capsule that is holding up your implant. At 9 months, there is no more dropping and fluffing without help. Please discuss this with your surgeon. External ultrasound treatments could be helpful.

At nine months post op you are basically looking at final results with no major changes expected from this point. If you have concerns about nipple asymmetry and implant position I encourage you to discuss it with your surgeon as well as options to correct it.

At 9 months, your implants have fully settled.
Your photos are suboptimal for evaluation. Dental and side photos with your arms at your sides and preop photos are required to properly evaluate your issues. Either way, it appears you will require a revision procedure
Best wishes
Dr. Taranow

Hi and welcome to our forum!
From your photos, there is apparent asymmetry of implant positions, although your arms are elevated at different "altitudes" and the nipple areolar complexes are masked.
The "drop and fluff" phenomenon occurs within the first 3 months as the healing skin and soft tissues redrape around the implant. At 9 months after surgery, the pockets are well formed and almost completely healed (usually complete at one year).
Implant malposition is not an uncommon complication of breast augmentation. One cannot totally predict how a breast pocket will contract during the healing process. Postoperative breast massage is usually recommended in attempt to prevent capsular shrinkage.
A pocket adjustment is recommended. 15% of cosmetic surgeries are improved with a secondary touch up procedure.
Revisit your plastic surgeon.
Best wishes...

Freetings,
9 months after your surgery, you are still aware of implant/breast asymmetry issues. You really should return to your plastic surgeon for a consultation and an examination. Your doctor's medical pre-operative photos might reveal if some of these positional concerns pre-dated your surgery.

An examination can determine if you have capsular contracture as a part of the appearance issues. Treatment options can then be discussed with you. You must weigh the risks of further surgery against potential benefits. The photos seen without an examination, do not provide an answer for your care.

Best Regards,