One Implant not dropping after 5 weeks (photo)

Question

I had a transaxillary BA 5 weeks ago and I see a lot of progress with my right breast. However, there is little to no progress on my left. It is still sitting very high. My dr told me to push the implant down while lying down, I am also wearing a band all day. My pictures are from top to bottom : 3,4,5 weeks post op. Is this normal for one not to move or should I be worried by now? I also have a vein and a knot sticking out under my left armpit from the Incision. Could that contribute as well?

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question and photographs.  It is quite normal to have one implant appearing different from the other at 5 weeks following breast augmentation surgery.  My strong advice is to wait a full 4-6 months before considering your final result.  You are likely still swollen and implants do take time to settle into the pocket.  Best of luck.

Stephen T. Greenberg, MD, FACS · Answer

Hello and thanks for your question. It can take up to 6 months for implants to fully settle and it is not uncommon for implants to settle at different rates. I have my patients massage their breasts starting at 1 week post op and spend about 5 minutes on each breast, 3-5 times a day. Sometimes a revision surgery is necessary to move the implant down, but that would not be a discussion for at least 3-6 months. You are still early in the recovery phase, but continue to follow up with your surgeon. Best of luck !

Kevin G. Rose, MD · Answer

The transaxillary approach to breast augmentation, unless a scope is used, can lead to the pectoralis major muscle only being stretched without being fully released leading to postop lack of implant descent over time. This may only be fixed by surgery. This is one of the reasons why I do not prefer the axillary approach. I have had to fix other doctors patients in this situation which requires an incision in the inframmamary fold or areola. Another cause of lack of implant descent is early onset capsular contracture. A good physical exam can distinguish these two problems. Good luck!

Daniel Barrett, MD · Answer

Dear kml17,Dropping of implants is part of the healing process and this occurs after the tissues surrounding the implants slowly relax, allowing the implants to settle into their final position. It can take about four to six months for the implant to drop down to their final position.I understand that you are worried about your implants are not dropping as expected. However, you are still in the early phase of the recovery period. Please do allow some time for the healing process to occur. If after six months, you are not satisfied with the appearance of your breast, you can visit your plastic surgeon and discuss your concerns.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Robert M. Tornambe, MD · Answer

kml17.  I see what you mean, however it is still quite early in your postoperative recovery period, and the overlying muscle and skin needs to relax to allow the implants to settle in. It is quite common for early asymmetry to occur but over time it may very well settle in without intervention. I would wait a minimum of 3 to 6 months after surgery before considering any revision and stay in close contact with your plastic surgeon. Best of luck.

Scott W. Vann, MD, FACS · Answer

I clearly see the asymmetry, but I think I see a little progress of implant a bit lower from 3rd to 5th week. I would give it at least another 6 weeks. Follow with your surgeon. Good luck.

Pejman Aflaki, MD · Answer

Hello
and thank you for the question and sharing your photos. Early after breast
augmentation, implants tend to sit high on the chest
wall, which make the breasts look unnatural. Over the course of next several
weeks, implants drop to their final location behind the breast
tissue. As they do, the bottom of the breasts (which look flat and empty
now) will round up and the nipple-areola complexes will rotate
upward. At the beginning, it's not uncommon for one implant to be at
a different level compared to the other one. As you mention in your post, one of your implants is not coming down as fast. My recommendation to you is to be more patient. Your final results can take up to 3  months to show. Stay in direct contact with your surgeon during this process. Wear your breast binder and continue breast massages as directed by your surgeon. There are a variety of factors that can result in implants not dropping, including inadequate pocket dissection during surgery and capsular contracture (scar formation around implants) among others. If the problems persists, you might need a revision down the line, depending on what's causing the problem. 
Pejman
Aflaki, M.D.
Johns
Hopkins-trained plastic surgeon

Anup Patel, MD, MBA, FACS · Answer

What you are experiencing is not abnormal as it is still very early in your healing process after a breast augmentation. Each breast may heal differently in terms of speed from one another. It is great you are keeping your plastic surgeon aware of the changes and healing as you experience it as this will help ensure best results for you. To fully see your results give it 6 months to settle and reduce in swelling.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well… 
 I have to say that you are still early on healing process, it is too
 soon to determine how your results are going to be, per now, they look 
very nice and beautiful, you can have one bigger than the other, feel 
swollen and also have bruises and open wounds, it is normal and that can
 happen for the first 3 to 4 months until your implants have dropped and settle in. 
Hope this is helpful. Good luck.-

Russell G. Hendrick, Jr., MD · Answer

it is normal for implants to settle at different rates after surgery.  You can expect your implants to settle for the next 3-6 months.  After that any unsettled implant will likely need surgery to bring it down

One Implant not dropping after 5 weeks (photo)

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