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At this point in your recovery, it is much too soon to beworried about the outcome. It takes time for the implants to settle intoposition and the skin and muscle to stretch out to accommodate the new implant. It may be 6 months or more before the shape has reached its finallook. Be patient.Implantmassage is a critical part of the postoperative recovery from breastaugmentation (like physical therapy is a critical part of the postoperativerecovery from knee surgery). The space for the implant is meticulouslycrafted at the time of augmentation surgery, especially when the operation isperformed using the surgical endoscope through the transaxillary approach. However, the distance from the nipple to the inframammary fold needs tostretch out to accommodate the implant (dropping) and the skin and muscle needto relax to give the desired shape (fluffing). Implant massage allows youto manipulate the pocket from the inside to direct the forces in theappropriate directions to mold the breast shape to the desired outcome. If the scar that is actively forming around the implant is allowed toheal without the influence of breast massage, the fold will not stretchappropriately (implant stays too high), the scar will attempt to contract in alinear way over the curved surface of the implant (breast shape will remain tooflat), and the space will attempt to heal smaller and tighter than the implant(capsular contracture). Implant massage influences the scar formation onthe inside at the most critical phase of the healing, allowing the space to be largerthan the implant (mobility which creates the natural feel and bounce). Implantmassage starts at one week at 5 times per day for one minute at a time andcontinues at this pace until one month. I often see the patients weeklyduring this time to reinforce the technique and help the patients who needextra effort to soften the breasts. During this time period, the massage alsobreaks up the spasm, relieving the discomfort, particularly upon awakening fromsleep (morning breast). During the day, every time there is the sensationof tightness, implant massage breaks up the spasm and relieves the discomfort,minimizing the need for narcotics. At one month, the force that can beexerted 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 asmaintenance. The patients integrate this into their shower routine. Althoughsome patients can get away with no massage, it is a common issue for those whostop the massage and make none of their follow up appointment to suddenly showup years after surgery claiming that they woke up one morning with a capsularcontracture and implant malposition. Of course this did not happenovernight, but was a slow process that could have been prevented with dailymaintenance massage and regular routine follow appointments on a yearly basis(which we provide for free, forever). With this type of perpetual follow up, itis possible to identify a problem early that might need a modification in themassage technique. Implantmassage involves moving the device up against the wall of the pocket, holdingpressure against the surface of the scar. The specifics are determined on anindividual basis guided by what the patient needs. In some patients it issimple and of little significance. In some patients it is a struggle toget the implants into the right position and to gain softness and mobility, butwith the right technique and the appropriate dedication it is a huge success. Forthe patients that do not participate in the massage in a meaningful way, somewill get away with their lack of dedication because they were going to havesoft breasts no matter what. On the other hand, some patients willsquander their opportunity to have an excellent result because they don'tbelieve that the massage is necessary, or because they have been told by theirfriends or other doctors that they didn't need to perform massage. Regardless, they often require surgery that could have been avoided byfollowing the postoperative instructions of a surgeon that has performed nearly10,000 breast implant operations and has seen the healing of each of thosepatients and integrated the successes and failures of each one into apostoperative plan that really works.I find no use for bands, straps, bras or appliances afterbreast augmentation surgery.
We generally tell our patients that it will take a minimum of three months for the implants to "drop" and become more a part of you. It may still be a little early in the healing process but be sure to keep follow up with your surgeon as you continue to heel. Good luck!
Thank you for your question and photographs, and it appears that you will have a very nice result. After placement of implants, the overall appearance of the breasts will change dramatically over the next several months, as the implants drop, and the overlying tissue stretches to accommodate the extra volume. It appears that you had fairly large implants placed, which can result in increased swelling and muscle tightness, maintaining your implants elevated. I know waiting is difficult, but judge your results at 4-6 months after surgery as most of your breast changes should have occurred by then. Hope this helps.
Hello, implants can continue to settle for months so it is possible you will continue to see improvement. it is important to have ongoing assessments by your PS to ensure you are making progress.
I appreciate your question.Right now, you are very early on in thepost op recovery period. It will take 3-6 months for you to feel comfortablehaving implants in your body and for them to settle. This time allows for youto physically and psychologically adapt to your new body image. There are manyvariables that contribute to a breast augmentation's final result. Preop sizeand shape, IMF location, location of the implants and type of implant. Patientsheal at different rates and each breast will sometimes heal at a differentrate. Rest, relax, recover and heal. Please Express your concerns to your surgeon sohe/she can examine you. Then reassess final result at 6 months.The best way to assess and give trueadvice would be an in-person exam.Please see a board-certified plasticsurgeon that specializes in aesthetic and restorative breast surgery.Best of luck!Dr. Schwartz
