Can underwire and poorly fit bras misshape or distort implants?

Thank you for your question. My patients will have a surgical bra that I place at the time of surgery. They normally wear this for the first week or two and then transition to a sports bra that opens in the front. By six weeks, if their implants have sufficiently descended, I let my patients know they can start wearing a normal bra (including a push-up bra). They may still undergo some changes which can change their bra preferences a few months later.

Typically the bra should not affect the position of the implant after augmentation surgery. The pocket dissection is what mainly determines implant positioning. That being said, an ill fitting or overly tight bra may push the implant too much in one direction causing it to heal in a strange position. But that would mean you are wearing this constricting bra continuously throughout your healing cycle over the first 6-8 weeks. In my opinion, this does NOT include sports bras. I like sports bras for the support they provide and the extra "hug" of security they offer patients in the healing stages. I have my patients wear a sports bra for a couple of weeks after surgery. With round silicone gel implants, I also have my patients massage the breasts starting one week out from surgery. I believe this softens up the scar that is starting to form and allows the implant to maintain its somewhat mobile positioning (like natural breasts normally move). As far as underwire bras are concerned, the main risk has to do with their effect on the scar. If the incision is  located under the breast, the wires in the bra can rub on the scar. This can lead to irritation and possible raising of the scar. I recommend my patients avoid underwire bras for 3 months after surgery to allow the scar to mature.  I also have my patients start massaging the scar at 3 weeks to encourage collagen reorganization and overall softening of the scar.

The primary concern is when to use an underwire bra after surgery.  The most common incision type for implants is a crease incision.  I usually give the green light for underwire bras at one month.  At this time it usually will not chafe the incision and the incision has enough strength.  Another concern is when is the right time to purchase a new bra that represents the size one will maintain.  I usually tell patients that this occurs somewhere between the 6-12 week period depending on skin type, size of implant, type of implant, stretch, and swelling.