5 weeks post op of Breast Augmentation, why is my nipple still pointed downward? (photos)

I am 5 weeks post op, 600cc high profile, smooth round mentor silicone under the pectoral muscles , donut lift , Have my breast completely drop and settle yet? Why my nipples still pointed downward to the floor and I can feel there are hard rings under the both areola incision and full of air? Is it normal for the implants move side to the bed when laying down?

Doctor Answers 10

Breast Augmentation

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From your photographs, the breasts appear to be healing well. There is continued swelling for up to 6 months following surgery and the implants take several months to settle and drop. Breasts move normally from side to side and an implant will continue to allow the breasts to move normally.  Incisions feel hard for up to a year until the scar tissue in the area of the incision resolves. Please be patient, healing takes time.

Orange County Plastic Surgeon
5.0 out of 5 stars 20 reviews

Nice result five weeks after breast augmentation and lift

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Thank you for your question.  You are very early in your recovery and your breast implants will continue to descend and as they do the nipples will have a more normal position and appear higher.  You have an excellent result for so early after a significant procedure.

5 weeks post op

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It appears as if you have a rather nice result so far despite having oversized implants and undergoing a periareolar lift. Your nipples appear to be very well positioned and are not pointed downward in my opinion. The implants will continue to settle and soften, the puffiness of the areolae will lessen, and the rings around the areolae will soften over the next 3 months or so. Be patient and follow your surgeon's instructions. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 90 reviews

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Swelling can distort the projection of the nipple and areolar complex.

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From the photographs it's apparent there is still a substantial amount of swelling in the nipple and areolar complex. This has to subside before a judgment can be made about abnormal nipple projection.

Healing After Breast Augmentation

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Thank you for your question about breast augmentation and healing.

Healing takes more time than people expect and it can be discouraging.  
  • You are still in the beginning stages of healing.
  • You are still swollen and things take time to heal. 
  • Usually it takes up to three months for the implants to settle down. As the swelling goes away, the implant softens and looks more natural.  Your nipples will settle too.
  • You will need at least six months to see your final result. 
  • If you have serious concerns, it is important to see your plastic surgeon because she/he knows exactly what was done for you.
Hope this helps.

Best Wishes.

5 weeks

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No, you will continue to have noticeable changes for some months yet. The nipples do no appear to be pointing down in the photos but nevertheless, rest assured that this is likely to improve more over time. The "rings" you feel are probably the permanent locking suture placed around the areola to maintain its size. The puffiness is common and normal and most often improves as the swelling and tightness improve.Be patient.
As for the implants falling to the side....that is normal to some degree but can be excessive if the pockets are too loose laterally.

5 weeks and all looks good

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If only 5 weeks you are looking fine. The periareola lift often has some swelling that takes 3-4 months to flatten out. Keep following you docs instructions and update us on your progress please. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Post Surgical Changes Following Breast Augmentation With Breast Lift

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The period of time immediately following combination breast lift/augmentation surgery is characterized by rapid change. During this dynamic period of time, swelling, muscle spasm, inflammation and the healing process itself all contribute to changes in the appearance of a woman's breast. In some cases, swelling and muscle spasm can displace the breast implants in a superior direction when implants are placed beneath the muscle. This can result in an artificial upper breast fullness and inferior malposition of the nipple areola complexes. Based on your pictures, I believe this is a distinct possibility.

In some cases, superior implant displacement may be due to inadequate dissection of muscle insertions of the inferior portion of the breast pocket. There is no evidence that this has occurred in your case. With time, assuming adequate pocket dissection, these implants might return to a more normal position. Sometimes, the use of a bandeau superiorly and massage can facilitate this process.

It may take 3 to 6 months for these implants to drop into a normal position. If no progress has occurred by then, revisional surgery may be necessary. This would involve recreating the lower portions of the breast pocket.

It's important to have good communication with your plastic surgeon. Make sure he's aware of your concerns. He is familiar with the specifics of your surgery and will be able to give you appropriate direction.

Takes 3-4 months to drop and settle

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It appears that your breasts haven't dropped and settled, yet. This usually takes three to four months, so please wait a little longer before assessing results. 

5 weeks post op of Breast Augmentation, why is my nipple still pointed downward? (photos)

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At 5 weeks post-op, it is too soon to worry about final results.  Everyone is different but it can take 3-6 months for your swelling to go down and implants to settle.  Try to be patient and give it some time.  Continue to follow post-op instructions and re-evaluate at that time because as your implants settle and swelling to goes down, your nipples will most likely move to a more central location on your breast mound and nipples rotate up.  Be patient.  ac  

Angela Champion, MD
Newport Beach Plastic Surgeon

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.