When will the implant reach the bottom of my breast? When should I start wearing strap and massaging? (photos)

I'm 6 days post op and I still have area under my implant. I can fill the implant when I push up but still hasn't moved down. I'm wondering if the implant is too big to move in the pocket or if something is going on. I haven't been wearing the strap because I felt I would give the first week healing time. I unfortunately don't have a surgeon in the same state I live and the surgeon I do have in Florida won't call me back to answer my questions. Should I start wearing the strap?

Doctor Answers 7

Not dropping

Generally speaking, especially early in the post-operative phase of healing, it is not uncommon to have one or both implants appear to be high up by the clavicle. Although the “pocket” may be made correctly, the implant may not have access to the bottom for several reasons. If the overlying muscle or skin is tight, this will move the implant to the path of least resistance which is up and towards the underarm where there is little or no pressure. As the pressure relaxes, the implant will drop down to the bottom. Smooth implants, because their surface is slippery, may move faster downward than a textured implant with its rough surface. Because these variables mentioned above can be different for each side, it's not uncommon that one side will drop faster to the bottom of the pocket than the other. Similarly, sometimes one breast will swell more than the other or be more painful than the other early in the postoperative phase. After the first month or two, usually things will even out. It wouldn't be, in my practice, until four months or so has passed that I would entertain going back to the operating room to “touch up” the location of the breast implant in the pocket. Sometimes specialized bras or straps as well as massage and stretching protocols may be helpful in allowing this process to happen more quickly. Each plastic surgeon will have different thoughts on what the best protocol is for the patient. Your operating plastic surgeon will be your best resource to have this information passed on to you. I recommend that you faithfully follow up and follow the instructions of your chosen plastic surgeon. Congratulations on your surgery, and good luck on an uneventful recovery.

Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Surgeon Not returning my Calls

Hi Kristina,Thanks for your question and photos. I would recommend wearing the strap right away. It will encourage your breast to drop as the implants are under the muscle and muscle tends to want to pull the implants higher upper on the chest. Your breast would not look this way if they were placed over the muscle. I tell my patients that they can do their breast implant displacement exercises if they want at one week after surgery to help the implants drop but there is no science to verify that these makes them drop. Some medications to help the muscle relax may help the implants drop. Continue to seek your surgeons recommendations. They have the best advice as they know what was done exactly. I am sorry that you can contact them, but seek their partner or someone who can reach them. Good Luck. Implants usually settle with time and it is still super early. 

All the best,

Carlos Mata MD, MBA, FACS

#highImplants #Underthemuscle

Board Certified Plastic Surgeon

Carlos Mata, MD, MBA, FACS
Scottsdale Plastic Surgeon
5.0 out of 5 stars 30 reviews

Post op drop

Thank you for your question and photos.  You are still very early in your recovery.  I would recommend wearing the strap above your implants.  Your implants should drop and settle, but you may want to find a plastic surgeon in your area to have in-person follow up to monitor your healing process. 
Best Wishes!

Jamie Moenster, DO
Tucson Plastic Surgeon
5.0 out of 5 stars 38 reviews

How to make implants settle down?

Thank you for your question Kristina. From your pictures, it is clear that your implants are riding high as is usual 6 days after surgery. Do not worry, the implants will settle down with the pressure of gravity. The pectoralis major muscle and the surrounding tissue has to get accustomed to the implant and loosen up a bit to allow the implant to descend. Once that happens, the implant will sit directly behind the breast tissue in a natural 45:55 breast ratio. Currently, there is excessive upper pole fullness (55:45), so in time, this will change. You can expect your final results in 3-6 months. For some of my patients with smooth implants, the implants had not settled until 5-12 months. Inward and downward breast massaging along with pole wraps above the breast do significantly help. Patience is key! However, ask your surgeon for specific instructions on how to do the breast massage. Also, when you lay down on the bed, try resting in an inclined way with your back against pillows so that gravity can still work to help the implants settle. Once again, your breasts will settle with time, but you should discuss this with your board-certified plastic surgeon. Try to get in contact with them by calling their office or by using the email if necessary. They will be in a better position to answer your questions because they know all the specifics regarding your surgery. Their instructions should take precedence over everything you read here. Hope this helps and best of luck!

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

When will the implant reach the bottom of my breast? When should I start wearing strap and massaging?

Wearing a pole wrap and doing pectoralis contraction exercises to help push the implant down should help your breast implants settle.  Fortunately it is still early but he need to take action.  Continue to try to reach your surgeon who should be willing to review your photos by email and make recommendations.

Breast dropping

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

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

6 days post op

Thank you for your question and the photos.Wearing the strap now will help them settle. Breasts settle at different rates and it does depend on the technique of breast augmentation that you have had. Do keep trying your surgeons office as you should be following the post operative instructions from your surgeon as every surgeon has their own protocol for post surgery care.Good luck

Chien C. Kat, FRCS
Birmingham Plastic Surgeon
4.9 out of 5 stars 86 reviews

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.