Techniques for Settling New Breast Implants?

I'm 4 weeks post breast augmentation surgery, and my surgeon wants me to sleep with a workout bra pulled up above my breasts to help push them down and drop more below my nipples. The first three weeks, I was in plastic bandages to keep them up. I had 300cc silocone under muscle, but was told that during surgery, my doctor decided to do lift because of my skin.

None of my friends have heard of this technique and their breasts settled in. Is this normal? My breasts do seem too high and my nipples too low. Are there other "techniques" for making the breasts settle the way my doctor wanted it?

Doctor Answers 33

Techniques to Help Implants "Settle"

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There are different techniques that surgeons use with their patients, including:

  • wearing an elastic garment that pushes down on the upper pole of the breast (Ace Wrap, specially designed bra, specially designed elastic strap, or what your doctor has recommended
  • manipulation or downward massage
  • sleeping prone(on your belly and chest)

These are all different ways to apply downward pressure on the implant to get the skin and muscle of the lower pole of the breast to expand to allow the volume of fluid (saline or silicone) in the implant to settle to the bottom of the implant.

This is different from an implant malposition, where the implant itself is just sitting too high on the chest.

If you can fell the bottom of your implants at the breast crease, the implants are not "too high;" it's just the fluid being displaced to the top of the implant by the tightness of the skin and muscle.

You may see one side "settle" sooner than the other: this is normal.

Follow your surgeon's recommendations, and allow at least 6-8 weeks for "settling to occur."

Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Many techniques, but time will be your best friend

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It's very common for implants placed under the muscle to seem too high early on after the augmentation-- this is due to anatomic reasons as well asthe swelling of the muscle that occurs during and after the procedure. We all have different ways to help implants settle into their final position, and in most cases it just takes time-- sometimes a few weeks, on rare occasion longer.

My advice would be to relay your concerns to your surgeon, but listen to his advice--chances are you will have a great result, but it will take some patience and time.

Dr. S

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Sounds like an inexperienced surgeon

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Making a decision intraoperatively to do a lift is unusual. It should be clear to an experienced plastic surgeon preop when a lift will be required.

Having your implants low and then high is also strange. Basically, you will settle over 6 months and know what your final result will be. Alternatives at that time include several options if the result doesn't meet your satisfaction. If at that time, if the breast looks low on the implant and the implant isn't sitting too high on the chest wall, you will need more lifting. If the implant is sitting too high on the chest wall, it will need to be surgically moved down. You also don't want to push down too hard on the implants because you don't want to have them settle too low and need further surgery to correct the bottoming out that has occurred.

Sounds like you need to stay in very close contact with your doctor and be monitored frequently for the next few months! Unfortunately, there are doctors out there who are afriad you won't come to them if they tell you that you need a lift plus the implant. The lift causes scars and costs more so some doctors hope to get by telling you that you dont' need a lift. Implants DON'T lift the breast, they only add volume. A lift is the only way to elevate the nipple and reshape a sagging breast.

Breast massage should be considered

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I agree that a breast "band-O" or simple ace bandage placed at the top of the breasts with consistent downward pressure will aid in dropping your implants into position. Also, I would recommend active downward massage displacement to each breast 4-5 times a day for about 15 seconds to each breast.

You will need regular follow-up with your surgeon to determine if this technique is working. Otherwise, if the implants do not drop within 6-8 months, you may need to consider surgical revision to lower the implants into proper position. I am a bit perplexed that you were not given the opportunity to discuss a possible lift with your surgeon pre-operatively. This is something that should always be discussed BEFORE surgery. Good luck!

David Rankin, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 168 reviews

Compression devices are an accepted technique for helping breast implants drop

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it is common practice to use a compression device to encourage breast implants to fall or be pushed lower after breast augmentation.

A common wrap called an "upper pole wrap" is commonly used, but your bra will work.

Downward massage can also help.

The description of the position of your breast implant sounds as though you may have needed a breast lift to put the nipple in a normal position.

When breast augmentation is done without a lift in this situation, the implant always looks high and pushes the nipple areola complex further down.

Hopefully the upper pole compression and massage will help your implant move down below the nipple areola complex.

If it does not, you may need a breast lift.

Settling Breast Implants

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Thanks for your question -

There are specific bandages and dressings that can be supplied by your surgeon to help put downward pressure on your breasts.

Massage may also help.

In all likelihood the most important factor is time. As swelling comes down and gravity does it work the position of your implants will improve.

Usually by 3-6 months the breast implants have found the correct position.

I hope this helps.

This is a very peculiar situation!

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Hi giross, This story took a lot of turns!!! First, DURING your surgery, the surgeon suddenly decided you needed a breast lift and performed this procedure? And this wasn't discussed with you beforehand? Then post surgery for 3 weeks you were wrapped in plastic to push the implants down? Now you've been instructed to wear a sports bra to push the implants up? And since surgery your nipples are low on your breasts? So many questions here. Much like your friends, I have also never heard of this! I would request a follow up to meet with your surgeon and address a few things: First, why would he not advise you pre-operatively a breast lift was needed to ensure a positive position of your areola/nipple? Second, how does he think moving the implant about in any way is going to change the position now? Third, set up a second opinion with another surgeon and get another set of eyes on this situation. Make sure the physician you're seeing is a board certified plastic surgeon with experience in breast lift and augmentation surgeries. I would be very curious to hear their take!

William Aiello, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Techniques for Settling New Breast Implants?

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There are many techniques for assisting breast implants to settle into their final position. It sounds as though your surgeon has recommended utilizing a sports bra to apply some constant pressure to the top of the implants to help them settle down faster. Other surgeons use different techniques, but I'm sure your surgeon has your best interests in mind, has most likely use this technique with other people, and with some time as well, I expect that you will get some settling in of the implants going forward. Wishing you all the best.

6 months to settle

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Your description of the decision to perform a "lift" sounds dubious unless you had this conversation with the surgeon preoperatively. Implants will descend with time and may take 6 months to reach their final destination. Wearing a tight garment over the top part of the breasts may speed the process of implant settling. I use a breast band on my patients that need this intervention. It can be worn night and day and may be more comfortable than pulling a sports bra up. Good luck!

That is a normal technique for pushing the implants down

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A few issues... I hope that the doctor explained to you about the lift BEFORE your surgery. Many times there is a possibility of having to do a lift, but you should be well aware of this before your surgery.

As for your implants settling, it is common to wear a special bra or strap to help push the implants into place if they are riding high. It is curious that initially you were told to push them up and now you are told to push them down. However, your doctor may just be trying to get them into perfect position for you.

Good luck with your recovery. It takes about 3 to 6 months for your implants to completely settle.

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.