Sports bra causes swelling and makes dents visible. Any suggestions? (photo)

There are likely two issues that need to be addressed in your post.  The first is the kind of bra you are wearing, and the second is the "dents" you seem to be seeing in your left breast.   First, with regard to the bras you are wearing, I am going to make a very objective evidence-based comment about that, but I’ll admit up front it might be contrary to what a lot of people around the world have been told about this.  Each surgeon has his or her own recommendations about bras to wear after surgery, and in the end, it is still always best to follow your own surgeon’s advice.  However, in all honesty, those recommendations aren't always based upon sound evidence.  I have found this to be the case with bras.  Recent studies have shown that out of six identifiable and statistically significant risk factors for capsule contracture, third only behind smooth surface texture and subglandular placement of implants, is a compressive postoperative bra.  That means that statistically, if you wear a compressive bra after breast augmentation, you may be subjecting yourself to the third highest risk factor statistically for capsule contracture!  I found that amazing, especially since most of us have always instructed our patients to wear a "good supportive bra" continuously after surgery for a certain period of time.  Now, we can debate what constitutes a bra that is "too compressive," or why this should even give us the statistics we have observed, but the bottom line is that those are the statistics.  I would venture to say at least that any bra which causes discomfort, swelling, or any other issues with the breasts postoperatively should be re-evaluated, and quite possibly abandoned.  I currently have my own patients wear a very light, very gently supportive, but not at all compressive, bra after surgery for comfort only, and if it’s in any way uncomfortable, we keep looking until we find something that is.  Many sports bras, in my opinion, are too compressive for early postoperative wear.  They are great to support heavy breasts during athletic activities once the tissues have fully healed and capsules matured, but until that time, I think they are more often than not more of a liability.  I encourage you to discuss this with your own surgeon and try to find a bra option that is comfortable for you and doesn’t add any additional problems or concerns.  With regard to the “dents” in your left breast, again, your own surgeon is going to be better prepared to accurately diagnose the problem as he or she is right there on the scene to examine you, but from the appearance in the one image you have shown, they look like the surface contours of the implant projected through your thin tissues in that part of your left breast.  It could be simply that an overly compressive bra is accentuating those ripples in that part of the breast by pressing on the implant too firmly, and that is why the sports bras seem to be making them look worse.  Many times  the two breasts have different amounts of tissue from one side to the other, and in areas in which the natural tissue may be particularly thin, especially if we use larger implants, the surface ripples and contours of the implant shell can be felt, or even seen, through the tissues.  As things settle and become more relaxed in the breasts this may change, but it may not.  In extreme cases we may ultimately decide that we want to do something to add a bit more camouflage to that area of the breast, such as placing a layer of ADM (Acellular Dermal Matrix), like Strattice or Alloderm, as further coverage to add thickening to the tissues, or even inject some fat graft to cover that part of the implant.  Again, discuss this issue with your surgeon so that you can get an accurate take on what exactly is going on there.  Best of luck.

Thank you for your question.I would recommend that you follow your surgeon’s aftercare protocol because every surgeon has slightly different post-operative instructions for their patients. If your surgeon recommended that you wear a sports bra then have him/her suggest what type or brand of sports bra and what size. You may be wearing the wrong size sports bra for your new breast size. You definitely want to address the dents in your breast with your surgeon so he can examine them and determine the cause of them.Best of luck in your recovery.Sincerely,

James Fernau, MD, FACSBoard Certified ENTBoard Certified Plastic SurgeryMember of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science