I had silicone 325cc full profile. The left side has dropped and gone back up a few times. Is this normal?

I had silicone 325cc Full Profile and am wearing a compression band since day 1 post op. The left side has dropped and gone back up a few times, each time it is sore again. Could this be from straining the left side? Is this normal? And is there anything I can do to help. Heat, ice ect...

Doctor Answers 6

Assymetry with Breast Augmentation Healing

It's still early in your healing process. #Healing will continue for 2-3 months following your #Augmentation #Mastopexy procedure. There may be some swelling, bruising, malposition, color differences. Sensation will be abnormal. Scars will also be changing.
But, it can be up to one year see your final result. Your doctor may require you to move or massage the implants within the breast pockets during the #postoperative period. #Textured implants do not require breast massage. You will be informed about this at your post-operative visit.
Also, the two breasts commonly heal quite differently so #assymetry is not unusual. One breast may swell more, feel more uncomfortable, or have a different initial shape. After complete #healing, they will be more similar and natural. You must have patience, but if this causes concern, ask questions of the doctor or the nursing staff.


Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Post op breast augmentation

Since I don't know where you are in your post op course, I really can't determine what is going on with your implants. Consult your plastic surgeon and he/she can guide you to what will work best for you

Susan Kaweski, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 4 reviews

With concerns after procedures

its always best to see your surgeon about this.  In addition to your surgeon getting to see your concerns, your surgeon knows what was done at surgery and what may be contributing to your perceived problem.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Depends on multiple factors

Hi Pamela.  It is always best to start off by relaying your concerns to your plastics surgeon.  Also, it would help if we knew how far along you are post-op to better assist you.  Make sure to seek the expertise of a board certified plastic surgeon with expertise in aesthetic breast surgery.  I hope this helps!

Sincerely,

Dr. Sean Kelishadi

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 22 reviews

I had silicone 325cc full profile. The left side has dropped and gone back up a few times. Is this normal?

See your plastic surgeon and ask about breast implant displacement exercises and pectoralis muscle contraction exercises.  I find that these maneuvers are quite helpful in encouraging breast implants to settle.

The utility of implant massage

After breast augmentation I find no particular advantage to the use of surgical bras. In fact, I find that they can do more harm than good. They hold the implants too high, preventing them from dropping into position. In addition, they can put pressure on the healing breast or the wound. They provide no advantage. If the surgery was performed correctly, external appliances after surgery are unnecessary to achieve the appropriate final implant position. At one month we allow the patients to wear a soft cup bra with no underwire. At two months, they can wear any bra with a wire without push up. Before three months it is not wise to buy a whole new set of bras. By six months, the bra size is not going to change. You need to try bras on. Being measured is almost never productive and almost always oversizes. Find the ones that you like the way they fit.

Implant massage is a critical part of the postoperative recovery from breast augmentation (like physical therapy is a critical part of the postoperative recovery from knee surgery). The space for the implant is meticulously crafted at the time of augmentation surgery, especially when the operation is performed using the surgical endoscope through the transaxillary approach. However, the distance from the nipple to the inframammary fold needs to stretch out to accommodate the implant (dropping) and the skin and muscle need to relax to give the desired shape (fluffing). Implant massage allows you to manipulate the pocket from the inside to direct the forces in the appropriate directions to mold the breast shape to the desired outcome. If the scar that is actively forming around the implant is allowed to heal without the influence of breast massage, the fold will not stretch appropriately (implant stays too high), the scar will attempt to contract in a linear way over the curved surface of the implant (breast shape will remain too flat), and the space will attempt to heal smaller and tighter than the implant (capsular contracture). Implant massage influences the scar formation on the inside at the most critical phase of the healing, allowing the space to be larger than the implant (mobility which creates the natural feel and bounce).

Implant massage starts at one week at 5 times per day for one minute at a time and continues at this pace until one month. I often see the patients weekly during this time to reinforce the technique and help the patients who need extra effort to soften the breasts. During this time period, the massage also breaks up the spasm, relieving the discomfort, particularly upon awakening from sleep (morning breast). During the day, every time there is the sensation of tightness, implant massage breaks up the spasm and relieves the discomfort, minimizing the need for narcotics. At one month, the force that can be exerted is increased but the frequency of massage decreases to 3 times per day. As the wound matures, the massage can decrease to once per day forever as maintenance. The patients integrate this into their shower routine.

Although some patients can get away with no massage, it is a common issue for those who stop the massage and make none of their follow up appointment to suddenly show up years after surgery claiming that they woke up one morning with a capsular contracture and implant malposition. Of course this did not happen overnight, but was a slow process that could have been prevented with daily maintenance massage and regular routine follow appointments on a yearly basis (which we provide for free, forever). With this type of perpetual follow up, it is possible to identify a problem early that might need a modification in the massage technique.

Implant massage involves moving the device up against the wall of the pocket, holding pressure against the surface of the scar. The specifics are determined on an individual basis guided by what the patient needs. In some patients it is simple and of little significance. In some patients it is a struggle to get the implants into the right position and to gain softness and mobility, but with the right technique and the appropriate dedication it is a huge success. For the patients that do not participate in the massage in a meaningful way, some will get away with their lack of dedication because they were going to have soft breasts no matter what. On the other hand, some patients will squander their opportunity to have an excellent result because they don't believe that the massage is necessary, or because they have been told by their friends or other doctors that they didn't need to perform massage. Regardless, they often require surgery that could have been avoided by following the postoperative instructions of a surgeon that has performed nearly 10,000 breast implant operations and has seen the healing of each of those patients and integrated the successes and failures of each one into a postoperative plan that really works.

I find no use for bands, straps, bras or appliances after breast augmentation surgery.

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.