Looking very weird and not dropping. Any suggestions? (photos)

Im 53 years old was 32aa and got 345 cc under muscle inframmary july 15. I worry now about cc. The skin is very tight under the incision i dont see how it could possibly drop into pocket or even stretch enough. These pictures are today at 11 weeks. I am very concerned and want to cry. What is going on? Very high and my nipples are at the bottom of my breast pointing down. Any thoughts or comments would very much appreciated

Doctor Answers 9

Breast implant settling after breast augmentation

Thanks for posting your question. I am happy to try and help you. It is important to remember that a board certified plastic surgeon will be your best resource when it comes to an accurate assessment of your situation, and concerns.

Having said that, it is common to have different women's implants settle at different rates over different periods of time. They will remain high for at least a few weeks. If your pre-existing anatomy has your breast creases or breast folds at different positions, they implants will settle to different places. So your preoperative anatomy has a lot to do with a final result. So does the skill of your plastic surgeon, size of breast implants, saline and silicone settle differently, skin quality and activity levels. You are still early so give it some more time. It may take 2-4 months to really see where you are.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Ashburn Plastic Surgeon
4.8 out of 5 stars 33 reviews

Asymmetrical Breast Healing Post Breast Augmentation

I know that it's frustrating, but I don't think you have anything to worry about. It is not atypical for each breast to heal and/or drop at a different rate. And though it doesn't feel like it, you're breasts are still healing. It can some patients up to 6 months for their breasts to fully heal and drop into their new position. For now, stay patient. However, if you are still concerned about this in another 2 weeks, then I would schedule an appointment with your surgeon to discuss. 

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Dropping takes months

This is definitely within normal limits for dropping.  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.

Gary Lawton, MD, FACS
San Antonio Plastic Surgeon
4.9 out of 5 stars 135 reviews

Implant issue

Your implants are obviously very high.    They may still drop over the next few months. If they do not then you will need a revision.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Not dropping implant

From the photos it appears that the implant on the right is higher than the left. Without the preop photos it is hard to tell if the right breast started out with a constricted look. It is not uncommon for the 2 breasts to drop at different rates. Ask your PS if this is early capsular contraction. Some vitamin E and asthma medicines have some effect in working to alleviate CC. Also ultrasound and now Acoustic sound waves are being used. Ask your PS about these modalities. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Looking Very Weird And Not Dropping. Any Suggestions?

Thank you for your question.

Your Breast Implants look very high. They may however settle down over the next few months. You should discuss this at length with your Plastic Surgeon. If the Implants do not settle down, there may be a need for another procedure.

All The Best !

Ajaya Kashyap, MD
India Plastic Surgeon
4.9 out of 5 stars 163 reviews

Implants looking odd

Thank you for you question and I'm sorry that you are having problems.  You are correct that your result is not what it should be in terms of aesthetic outcome.  Without having pictures of your breasts before surgery, it is difficult to judge what has gone wrong, but your implants currently are way too high and need to drop soon or another surgery may be warranted to drop them.  Ask your surgeon about a bandeau to help press the implants down and make sure to keep regular follow up appointments every couple weeks until the issue is resolved.   Again, I'm sorry you're having problems and best of luck with your continued recovery!

Jeffrey A. Sweat, MD
Sacramento Plastic Surgeon
4.9 out of 5 stars 44 reviews

Looking very weird and not dropping. Any suggestions?

I appreciate your question.
It will take 3-6 months for you to feel comfortable having implants in your body and for them to settle. This time allows for you to physically and psychologically adapt to your new body image.  Please do contact your Surgeon so he/she can examine you since you are at the 3 month mark and are also concerned about capsular contracture.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

Looking very weird and not dropping. Any suggestions?

Hi.. thank you for the question and photos...sorry for how you feel..  they seem to be very high... they should drop... 

Luis A. Mejia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 66 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.