Am I bottoming out or are my implants just settling at different rates? (photos)

Question

Does it appear I’m starting to bottom out? Or are my implants just settling at different rates? My left breast has dropped significantly and my right breast has stayed put. My right breast feels soft even though it looks pretty stiff. I posted my before, after and recovery photos.

Ozge Ergun, MD · Answer

Asymmetry in the breast tissue: Even before breast augmentation, some women have asymmetrical breasts. If the breasts are not the same size or shape, the implants may settle differently.

Implant size and type: The size and type of implant used can also affect how quickly and evenly the implants settle. Saline implants tend to settle faster than silicone implants because they are filled with a liquid that can move around more easily.

Healing process: Every person's healing process is different and some people may experience more swelling or fluid buildup than others, which can affect how the implants settle.

Incision location: The location of the incision can also affect how the implants settle. Implants placed through an inframammary incision tend to settle faster and more symmetrically than those placed through a transaxillary incision.

It's important to keep in mind that breast implants may not settle completely for several months after surgery, and any asymmetry may be more pronounced at the beginning. It's best to discuss your concerns with your surgeon and follow their recommendations for post-operative care.

Brian K. Reedy, MD · Answer

Hi & thanks for your question!
Implants can take 3 to 6 months to drop and settle into position. One may drop before the other. Continue to follow your instructions and contact your surgeon with any questions or concerns. Best wishes!

Albert Ko, MD · Answer

Hi there, from your before photo it appears the inframammory fold on your right breast is naturally higher than the right side. Both sides of your body are never perfectly symmetrical, so that may be contributing to the unevenness of your breasts now. After breast augmentation, everything because exaggerated. I would reccomend consulting with your surgeon, it also depends how long ago your surgery was and how far into the healing process you are.

Daniel Barrett, MD · Answer

Dear jll14,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  It does not appear that you are bottoming out but you also did not mention timing since surgery. I would allow a full 6+ months to pass before assessing your results in order to determine the potential need of a revision as it is common for the two sides to heal at different rates.

James M. Economides, MD, FACS · Answer

It is difficult to tell from the photos and description whether the implants are bottoming out or settling at different rates. How soon after surgery were these photos taken? What plane were the implants placed? Do you have standardized photos taken at a direct head-on angle? Early in recovery the implants may settle at different rates. This becomes less so as time progresses (6-12 months after surgery). Depending on the size of the implant and tissue quality, you may be at higher risk for bottoming out. It is best to return to your surgeon to voice your concerns and answer your questions.

Derek Fletcher, MD · Answer

It does not look like your implants are bottoming out. Your before photos suggest your right breast inframammary fold was naturally 1-1.5 cm higher than your left and that your right breast was slightly smaller. Implants often settle more slowly on the smaller side, especially if the inframammary fold is higher.

Camille Cash, MD · Answer

It does not appear that you are bottoming out.  It does appear that one implant has settled into the pocket and the other is not quite there.  If you are less than 6 months from surgery you may notice changes still ahead.  I encourage you to discuss your concerns with your surgeon who can best advise how to proceed.

Douglas Taranow, DO, FACOS · Answer

The fact that your right side implant is soft goes against a capsular contracture and more towards the implant not dropping.  This usually requires a revision breast augmentation with a partial right capsulectomy.  Return to your implanting surgeon for their evaluation.
Best wishes.
Dr. Taranow

Connie Hiers, MD, FACS · Answer

Your right implant has not yet dropped completely and may because this is your dominant side. Go back to your surgeon and discuss your concerns. Your surgeon may want you to take Accolate to help soften the pocket and even use external ultrasound treatments to get the implant to settle more.

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