Is It Normal for my Breast to Look Pointing Down After a Breast Augmentation? (photo)

Before my surgery I was size A, i am 5'4 125 pounds. I got 500cc silicone under the muscle implants and its been 2 months since surgery.

Doctor Answers 22

Nipple/Areola Pointing Downward after Breast Augmentation Normal?

Yes, what you  are experiencing is quite commonly experienced after breast augmentation surgery. It may take several additional months for your breast implants to fully “settle” into their pockets. Some patients referred to this process as “drop and fluffing”. As this occurs, it is very likely that you will notice your nipple/areola complexes pointing more forward,  as opposed to downward.

Ask your plastic surgeon if he/she would recommend the use of a bandeau  or massage  to help with this process.

 Best wishes.

Is It Normal for my Breast to Look Pointing Down After a Breast Augmentation? (photo)

Sory for the post operative issues.  If after a month post op your implants are still riding this high you will need a face to face with your surgeon. In most cases the implant "fall" into the inferior pocket over the course of a moth +/-. But consideration must be given to the possibility your inferior pocket was under dissected, you may have needed a lift, or both.

Thank you for your question . 

Time, Weight and Gravity are on your side

Your appearance is temporary and will resolve over the next few weeks.  The fullness of the superior margin of the breast is the top part of the pectoralis muscle.  Give it time and the implants will settle into position.  Time, Weight and Gravity are on your side.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 14 reviews

Large implants, small breasts, and time.

Typically, when implants appear too high, it is due to one of two issues: Either the implant pocket IS too high because the proper release at the fold was not performed, or the breast did not have enough stretch to accomodate the implants. Implant "settling" or "dropping" should actually be termed "breasts relaxing". 500cc implants are considered "large" implants. Placing these in a small, tight, A cup breast pocket will take a considerable amount of time before the skin responds and expands to accomodate the implant. Bra bands and downward massage can help hasten this process, but it is time and gravity which are the main contributors. If your breasts do not accomodate by 6 months postoperatively, you may wish to have a revision.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 15 reviews

What is normal after an augmentation

will vary from patient to patient.  If you wish to have the fullness in your upper poles and value that over anything else, then it is 'normal' in your case.  If you wish to have a more natural look, you should be working hard at trying to help your implants settle more.  Hopefully you have discussed your concerns with your surgeon as you were recovering from your surgery and that he/she was helping you through the healing process with known methods of helping implants settle.  So the answer to your questions is 'it depends'.  And if you want a more natural look and you cannot get your implants to settle more, you are probably looking at a revision to better position your implants.  Good luck!

Curtis Wong, MD
Redding Plastic Surgeon
5.0 out of 5 stars 30 reviews

Your final nipple/areola position should not be pointing down


Thank you for the question and photo.  You final breast shape and nipple/areola position should have the nipple/areola pointing level with the ground.  At this time it your implant volume is still a little too high in the upper pole and not enough in the lower pole of your breasts.  This may be because your muscle is still too tight, the breast skin/tissue in the lower pole is too tight, or your pocket was created to high.  At 2 months it is still too early to tell if your breast shape will mature properly on its own.  I would continue to follow your plastic surgeons instructions which may include aggressive downward massage, upper pole bandeau, and wearing loose fitting sports bra.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 144 reviews

Breast Implant Sizing

Depending on how large an implant you choose, it may be normal to have extra fullness above the nipple right after breast augmentation. As time goes by and you massage the implants downward, the lower part of the breast tends to fill out and get more natural looking. Most changes occur in the first six weeks to four months. The breast can even tend to look more natural over a year or two. After a sufficient amount of time, you can assess whether you like the shape of your breasts and explore your options if you do not. 

Breast implants too high after surgery

I would expect that your implants should have dropped by now.  Give it another month or so - your tissues will likely continue to stretch and the implant may drop a bit more.

From your photo, it appears that the implant may be too big for your chest - not an uncommon problem when patients and their surgeons "guess-timate" what size implant "should work" instead of choosing an implant based on the size and shape of your chest and breast.


Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 8 reviews

Temporary misshape of the breast is common after breast augmentation.

The volume of the implants is being artificially supported by swelling in the tissues of the breast and chest.  When the swelling subsides, the volume will be distributed in a more naturaly way (described as "dropping")

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 25 reviews

High implants

The implants are high right now.  Two months out I would expect then to be a little lower.  But sometimes it takes three months.  I will say they are big implants for small breasts and a small body.  I think they may always a look a little high due to implant pocket disproportion 

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
5.0 out of 5 stars 43 reviews

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.