How Much Smaller Will my Breasts Get Once Swelling Goes Down? Im Worried I Went Too Big?

Question

I recently had a BA surgery. I am 5'0'' and 110 lbs. I was a 32a and had 350cc implants put in, submuscular. Its been a week after surgery and I'm really worried I went to big. They're about D'c right now and I was looking for about a C cup. I hate how I look top heavy now and am becoming more and more self conscious, how much will the swelling go down?

Richard H. Tholen, MD, FACS · Answer

Your 350cc implants can be expected to add about 1 1/2 cup sizes to whatever breast volume you started with, but "too big" is one of those subjective assessments that depend on so many factors.

	Careful surgery with precise technique (even below the muscles) yields almost no bruising and usually minimal swelling, but there are still surgeons who use blunt dissection, minimal cautery bleeder control, and toss in a drain to evacuate the bleeding. These surgeons also usually use a surgical bra or Ace bandage wrap to help put pressure on bleeding vessels. The usual result is LOTS of bruising, LOTS of swelling, and a somewhat longer more uncomfortable recovery for their unwitting patients. (And, a higher risk of capsular contracture or re-operation.)

	Even if you had the most careful, precise operation possible and hardly any bruising or swelling, your tissues still have to accommodate to the presence of your implants, and you can expect your breasts to soften, settle, and drop over time. This is usually perceived as decrease in size and improvement in natural appearance and softness.

	Also, if you buy your bras at Victoria's Secret you may fit best into a D-cup bra, but bras by most other manufacturers will be a C-cup with equally-good fit. The letter on the label does NOT determine your breast size, any more than a particular shoe size should be considered "gospel."

	Be patient with yourself, and don't worry. Keep up a dialogue with your surgeon, who wants you to be as happy as possible! Best wishes! Dr. Tholen

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.It can take quite a while for patients to see what we as surgeons see in the operating room.  Implants, especially when placed below the muscle, tend to look a little 'high, hard and ugly' immediately after surgery and can take 3-4 months until they have settled and are in the proper position within the breast pocket.  It takes some time for implants to settle because the muscle and skin/tissue has to stretch to accommodate this additional volume that the implant has brought to the breast.  For these reasons I would caution you from judging your results only a few weeks out from surgery.  As your body stretches to adapt to your new implants, everything should settle into place and  you will find that it is during this period that your breasts appearance will continue to change and evolve.  Things always look a little 'odd' immediately following a breast augmentation, but most patients are ultimately happy with the size chosen once they have fully healed and the implants have had time to settle (if anything, patients will wish that they would have gone a little bigger!).  I would recommend following up with your operating surgeon to discuss your concerns and to have your progress evaluated thus far.  Breast massages can help to facilitate the settling process and softening of your implants, and this is something I would encourage that you discuss with your operating surgeon if you have not done so already.  I hope you find this helpful and I wish you the best of luck on your recovery.

Ali Sajjadian, MD, FACS · Answer

Hello,

	Naturally, swelling will occur after a breast augmentation and the chest of the patient will look larger than anticipated.

	With that perspective, at one week post op I do not think that you are any different and your best bet at the moment is to follow your surgeon's post-op instructions religiously and be patient giving nature the chance to take its course.

	Therefore, it is not possible to assess the results of your surgery unless you accomplish full recovery.

	Nonetheless, you should have a fair idea on how your breasts will look like at about 6 months into the race; often patients with similar cases like yours end up very satisfied with the size of implants they have chosen once the swelling has resolved and the implants settled into their natural position.

	Additionally, I recommend that you keep your surgeon in the loop of your recovery process.

	I hope this helps.

	Thank you for your post.

	The best of luck to you and congratulations on your surgery.

	Dr. Sajjadian

Martin Jugenburg, MD · Answer

Thanks for your question...You are early post op and it can take up to 3 months for your breasts to "fluff and drop". If you are still concerned please speak to your surgeon. You can learn more on our social media (Instagram and Snapchat): @realdrsix.
  
Regards,

Larry S. Nichter, MD, MS, FACS · Answer

Two things happen and seem paradoxical. As as the swelling  goes down there will be some shrinkage but at the same time as the muscle relaxes your breast projection grows. In general the breast shape and size proportionality improves..Breast implants initially after surgery when placed in a submuscular position often give superior fullness that corrects itself with time, the "fluff and drop" phenomena. In reality the pectoralis major muscle takes a while to adjust its size to accommodate the implant as well as occasional muscle spasm which keeps the implant projection higher than its final resting shape. Additional variables include:laxity of skin, size difference during prior pregnancies, position of implant,size of muscle, and size of implant.As the muscle relaxes the projection of the implant often increases and the breast shape improves. Massage and use of a superior placed elastic strap can often make this process go faster.

Young R. Cho, MD, PhD · Answer

Thank you for your question.  During the post-operative period the breast are swollen, and the breast implants appear in a much higher position.  Over time they descend and fills out the lower half of the breast.  It may take several months for this to happen and can be encouraged with breast massage and compression. After the swelling goes down the breasts will appear smaller.  However, as the implants settle, it may appear that the breast enlarges as the lower aspect of the breast fills out (at the expense of the upper portion of the breast).

Richard J. Bruneteau, MD · Answer

We frequently see patients who express concern about the
size of their breast implants following breast augmentation surgery.  In some cases, this occurs in the immediate
post-operative period.  The majority of
these patients are concerned that their breasts are too big rather than too
small.  As swelling subsides, most of
them are ultimately happy with the breast size.

Immediately
after surgery, it’s hard to make judgements about breast size because of
swelling and muscle spasm.  It may take
weeks for the majority of swelling to resolve. 
In addition, muscle spasm can increase upper breast fullness and make
the breasts look larger than they really are. 
This may also take weeks to resolve.

Many
patients also experience transient adjustment reactions following breast
augmentation.  These patients have
difficulty adjusting to larger breasts and often feel as if people are staring
at them.  With the passage of time, most
of them are able to adjust to their new implants.  Eventually, they may even forget that the
implants are there.  The adjustment
process varies from patient to patient but may take months.

Immediately
following surgery, it’s not unusual to see patients who feel that their breasts
are too large.  After several months,
they adjust to their new implants.  They
feel that their new breasts fit nicely on their body and they are happy with
their results.  Occasionally, some of
these patient request even larger implants.

If
you have concerns about breast size following breast augmentation surgery, you
should communicate with your plastic surgeon. 
He has dealt with this situation in other patients and can address many
of your concerns.  With time, many of
these concerns may resolve without intervention.  Ultimately, you may still be very happy with
your breast augmentation.

Jerome Edelstein, MD · Answer

The size of your breasts at the moment is definitely being affected by swelling, but it is difficult to say by how much this swelling is affecting your breast size. In a few more days, the swelling and bruising will gradually subside, and for the majority of patients, most swelling will resolve within 2 weeks of your surgery. Your implants will gradually settle in the weeks after surgery (aka "drop and fluff").  This normally takes about three to four months, so i suggest waiting until then before you assess your results. If you're still unhappy with the size of your breasts, then you can consider revision surgery.

Pedy Ganchi, MD · Answer

There is always some swelling and tension in the early stages of healing after breast augmentation along with excess bulging of the pectoralis muscle. The breasts can therefore appear too large or full in the upper pole. This usually resolves in one month as the muscle relaxes and the implants settle into place. An A to C cup is a significant size enhancement and requires some time for you to become accustomed to your new look. It's best to allow for proper healing prior to judging exact bra cup size.

Sean Doherty, MD, FACS · Answer

it is very common for patients to be worried about their size after surgery. It is one week you are still swollen and your implants are riding very high under your muscles. Your swelling will settle and your implants will come down. These are very common concerns. I recommend staying in touch with your surgeon—he or she will want to reassure you.

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