Unnatural Results After Breast Augmentation?

Why do some post-op girls have that "frankenboob" look immediately after their breast augmentation surgery, while others look more natural? Mine look like snoopy boobs immediate after surgery, and there is a square like bulge on the top portion of my breasts. Does it have something to do with the technique?


Doctor Answers 17

The immediate result is temporary

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The immediate look after a breast augmntation depends on the size and profile of the implant inserted, the strength of your muscle contraction over the implants, the initial shape of your breasts, and the degree of swelling you have. Each person looks different the next day after surgery than they did on the operating table. Some a bit more distorted than others. It is important not to focus on this and follow your doctor's massage instructions and wait 2-3 months for most of this to relax away.

Many things play into breast augmentation results

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Right after surgery, things tend to look funny. This tends to get better with time. How much time relates to how much tissue the patient had to cover the implants and how large the implants are. Implant shape can play into this as well. Larger implants in thinner patients tend to look funnier at first and don't become as natural-looking as time passes.

The surgeon's technique and judgment are also important. As we become more experienced and have seen and done more, we get better at knowing how things end up. That is one of the things you pay for with a more experienced surgeon.

Early on, scary-looking boobs can be quite normal for your surgeon's technique. If you don't see your surgeon you may not know this however. This is one of the reasons I believe in personalized follow-up plans with my patients, so they can know they are doing fine and can relax.

John P. Di Saia, MD
Orange Plastic Surgeon

It has everything to do with patient selection, surgical judgement, and technique.

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To stomachsleeper,

Hi. It sounds like

1) either your implants are too high in relation to your breast tissue,

2) or you needed a lift together with your breast augmentation.

It is hard to generalize, because there are literally dozens of details. Snoopy boobs don't sound good. You may need a revision in a few months.

What I do to try to avoid problems like this, is put the patient into a sitting position DURING surgery. Then I can see if the shape is great without any guess work before the end of the operation. If it is not great, I keep working.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon


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Excellent description. You obviously have a good sense of humor. I think you need to go in and discuss things further with your plastic surgeon. Hopefully, he is as personable as you seem to be. Waiting may still be the answer at this point. Try to work this out with your current surgeon. Good luck.

Jack Gelman, MD
Frankfort Plastic Surgeon

Early on, un-natural is normal.

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During our pre-operative discussion all my patients learn that they will look rather un-natural immediately after breast augmentation surgery. That is normal. Tighter skin and breast tissue and larger implants accentuate this. Mild relaxation of those tissues from previous pregnancies and breast-feeding minimize this.

The gradual change in appearance is caused by gradual relaxation of the width and radius of the lower half of your breast, under the influences of gravity and the weight of the implant. The improvement takes place over the first 6-8 weeks, and more gradually afterward.

Much of this happens to all patients regardless of surgeon, implant or methods and techniques used. (See modifications mentioned above). We monitor it during the post-op follow-up care. Talk with your surgeon during your visits.

As mentioned by other plastic surgeons here, if your breast, nipple and areola drooped too much before surgery, augmentation without mastopexy (lift) won't give you complete correction.

Sutton Graham II, MD
Greenville Plastic Surgeon

Frankenboob? That is scary!

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Square upper pole of the breast is something I have not seen so I can't comment.

The other issues have to do with technique, and muscle spasm. I tell all my BAM patients that the muscle spasm will start to relax after 3 to 4 weeks, and at that time, they will start to look better and more natural.

Also, this is more common when the implants are placed under the muscle.

Side effect of breast implants: Natural look or not? What factors determine this?

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There are all sorts of reasons why this happens and I have to give you an oversimplified analogy to explain complex anatomic interactions.

If you take a baseball and cover it with a silk sheet, you will see everything: a hard round, firm, irregular (stitching) blob that is very unnatural looking. IF however, you take the baseball and cover it with a thick comforter, the baseball will have a soft, mound like appearance that will create a more gentle impression. IF you change that baseball to a volleyball even under the comforter, it will look excessively large and round.

My point is: there is an interaction involving the implant (ball) and the covering (your breast tissues). Some characteristics of the implant we can modify (size, shape, composition of implants, surface) and some aspects of the breast we can alter as well (under/over the muscle, volume of breast, loose skin, position of nipple) while other things we can't. There is one other factor that is difficult to predict and that is settling of the breast. We generally know that implants will initially ride high. However as they settle, the implants will descend. Some more than others. But this is not always predictable in the short and long term.

Clearly the women you describe as looking natural, most likely had smaller implants for their bodies. The amount of breast tissue can also contribute to the snoopy appearance if it "drops" off the implant. To some degree, it is probable that your breast implants will descend but how much is the question. Breast implant displacement exercises may facilitate this change. I would advise avoidance of underwire bras which will maintain the superior position of the implants.

Discuss your concerns with your surgeon.

I hope this helps.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Post-Operative Breast Implant Elevation

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It's not unusual for patients to have superior malposition of their breast implants in the immediate post-operative period. The period of time immediately following breast augmentation surgery is characterized by rapid change. During this period of time, swelling, muscle spasm and the healing process all contribute to changes in the appearance of a woman's breasts. In some cases, swelling and muscle spasm can displace the breast implants in a superior direction when implants are placed beneath the muscles.

With time, assuming adequate pocket dissection, these implants usually return to a more normal position. Sometimes, the use of a bandeau superiorly and massage may facilitate this process.

It may take 3 to 6 months for these implants to drop into a normal position. If no progress has been made by then, revisional surgery may be necessary.

If you're considering breast augmentation surgery, it's important that you discuss your concerns about this issue with your plastic surgeon. Your surgeon should be able to explain his approach and alleviate your anxiety.

Factors which Contribute to the Outcome of Breast Augmentation

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The factors which contribute to the outcome of Breast Augmentation are #size, #shape, and #profile.

Depending on the type of implant used, also contributes to the appearance. Each implant have their benefits. #SalineImplants is made with a #silicone outer shell that is filled with saline water during the surgery. It is filled with sterile saline (salt-water). Since saline is like normal body fluid, it is safe and easily absorbed if the implants were to leakThe #implant shell is ordered in a specified size which can be filled to a minimum or maximum fill amount. This allows the plastic surgeon some flexibility with sizing during surgery. Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry. Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer. A new saline breast implants option called Ideal Implant™ was recently FDA approved and was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than traditional saline implants on the market. The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline.
#SiliconeImplants are made with a silicone outer shell and are filled with a gummy-bear consistency silicone on the inside. More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material.

#Subpectoral or #submuscular implants refer to placement under the muscle which still remains the most common placement in the United States. #Submammary or #subglandular implants are the placement under the breast tissue in front of the muscle. This tends to more common in Europe and South America. General guidelines suggest that women with larger drooping (ptosis) breasts that do not want a breast lift often have the implant placed above the muscle, although another option, #DualPlane, has become more popular. In the Dual Plane method, the implant is placed under the pectoralis muscle but the breast tissue is also release, in part, from the muscle. Those patients with minimal breast tissue should usually have the implant placed beneath the pectoralis muscle for more soft tissue padding.

Also, without a Breast Lift, the breasts may appear larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. It's also possible for a “Snoopy” breast or double bubble to develop as a result. The implant with lift can also re-position the nipples which may have been affected by ptosis or drooping. One of the primary intentions of a Breast Lift (#Mastopexy) is to improve the shape and position of the breast without reducing their size. It is used especially for breasts which sag or droop (#ptosis). Lastly, another important element to a satisfying result of your #augmentation is realistic #expectations.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Unnatural results after breast augmentation

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Breast implants will "settle" to some degree and too much fullness in the top of the breast may be very normal in the immediate stages post operatively. However, we all have seen this as a permanent result in some before and after photos.
A common error that leads to an unnatural appearance after breast augmentation, even with implants of an ideal size, is inadequate lower pole dissection and/or inadequate release of the pectoralis major origin just above the inframammary fold. As a result the implants sit too high and appear excessively full in the upper poles (the area above the nipple-areola complex), while the lower poles - which should be the fullest area of the breast - are underfilled. Inadequate muscle release may also result in bizarre-appearing breast implant animation when the pec major muscle contracts. In some cases this may result in one or both of their implants jumping up literally to the level of a patient's collarbones - an alarmingly unnatural look, and one that is totally avoidable 


A shaped form stable breast implant can give the patient the lowest risk of fold and ripples in the lower pole, the lowest risk of a visible transition between natural breast tissue and implant  (sometime refereed to as a double bubble) and the lowest risk of breast implant malposition with the breasts bottoming out. I think there is a performance difference between form stable breast implants. Consult with plastic surgeon who have experience and expertise perfuming this particular procedure. 

In many breast augmentation patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola. Ideally the implant should be centered directly behind the nipple-areola complex (NAC). In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. In addition, inadequate release of the inferior origin of the pectoralis major will allow the muscle to hold the implant in too high a position, and may even cause the implant to displace upwards (as high as the collar bone in some patients) when the muscle contracts. Patients with this problem require reoperation to release the inferior origin of the pec major and/or the inframammary fold.

Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance, and one that requires surgical correction: repair of the inframammary fold(s).   

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 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.