I am almost 6 weeks post op and am concerned as the right breast has yet to drop. Is this normal? (photos)

I'm almost 6 weeks post op and the right breast ( left if looking at the pic ) is still high and full on top and the nipple is pointed downwards. Before pics show the breasts seemed to be similar in size and nipple position but I'm getting really concerned as the left one dropped and the lower pole filled out fairly quickly ( right around week 3). I'm right handed so I'm hoping that maybe that muscle just hasn't relaxed but I'm massaging everyday and it doesn't seem to be helping.

Doctor Answers 14

Breast implant settling after surgery

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Hi aksmith625. Many thanks for your post. All seems to be progressing well for this stage. It is not uncommon for the implants to settle at different rates. I would continue massaging the right implant to encourage it to come down. If the implant is still high at 4 months, you may well benefit from lowering of the pocket but hold tight for now. Good luck!

Implant high

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It appears as if one of the implants has yet to settle. It can take more than 6 months for an implant to settle. This may be due to either a capsular contracture, or, more commonly, the bra has not allowed the implant to settle yet. The illusion is that one nipple is lower but in reality, the implant is too high. Aggressive massage and not wearing a bra sometimes helps. If it has not changed after six months, a quick surgery can lower it. If it is a capsular contracture though, it is a much more complicated problem. 

I am almost 6 weeks post op and am concerned as the right breast has yet to drop. Is this normal?

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Congratulations on having undergone the breast augmentation procedure. Generally speaking, breast implants will "drop" into the pocket that was created during surgery and massaging the implants downward may assist in the dropping of the implants after surgery (for those patients who want to help with the settling of the implants). The rate of breast implant "settling" may depend on factors such as size of breast implant pocket dissected, tightness of the overlying skin/muscle layers, and size of breast implant utilized. Normally, it takes about 3-6 months (for some patients longer) to see the final result. It is very common for one side to settle faster than the other.
In cases where significant breast asymmetry persists, the pros/cons associated with revisionary breast surgery should be carefully considered prior to making decisions whether or not to undergo further surgery.
Best wishes for an outcome that you will be very pleased with.

One implant higher than the other

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I would encourage you to continue to be patient and allow the implant to gradually fall into position. Quite often it is just a matter of time before this happens. Generally, I would wait 3 months before even considering surgery to correct this.Make sure your surgeon is aware of your concerns.Hope this helps.

Joel M. Stewart, Jr., MD
Newnan Plastic Surgeon

Implant dropping into place

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Thank you for your question and photo.  I would allow a few more months for the right breast implant to drop, however, if your right nipple is slightly lower than the left, you will have the same issue after an augmentation.

Breast not dropping

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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.

I am almost 6 weeks post op and am concerned as the right breast has yet to drop. Is this normal?

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Thank you for your question and photographs, and it appears that you will have a very nice result.  After placement of implants, the overall appearance of the breasts will change dramatically over the next several months, as the implants drop, and the overlying tissue stretches to accommodate the extra volume.  At six weeks, your implants appear to be settling, with your left having dropped a bit sooner than your right.  This is very common.  I would anticipate your right breast implant to follow suit within the next two weeks.  I know waiting is difficult, but judge your results at 4-6 months after surgery as most of your breast changes should have occurred by then.  Hope this helps.

Implants dropping at different rates.

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Your concerns are well-stated and your photographs illustrate understandable concerns. You may indeed be right about your right-handedness being part of a reason for asymmetry in implant drop rates, plus it can simply be differences in healing from one side to the other.

It sounds as if you are following your surgeon's advice, which is good since it is s/he you will have to go to for further advice or corrective surgery. But let's hold up for a bit! You're only 6 weeks post-op.

If you were my patient, I would have you continue implant displacement exercises to keep your pockets open and slightly larger than your implants, so your breasts stay soft and naturally-shaped. But I would also have you wear an elastic bandeau above your right breast and below the left ("Mexican gun belt" style) each night (not during the day) to aid in dropping the "slower" implant. You will need to ask your surgeon about this, and I have found that having my patients wear a T-shirt over the bandeau and safety-pinning the bandeau to the T-shirt helps keep it in place as you sleep. Over time, this aids in equalizing implant position. 

Complete healing takes 6-12 months, so you have plenty of time to influence your final result, which looks as if it will be excellent. Ask your surgeon and don't worry. Best wishes! Dr. Tholen

S/p BA

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Best advice is to follow up with you surgeon. They can examine you and perhaps show you how to perform massage to your breasts which can be helpful in situations like yours.

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

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I appreciate your question. Right now, you are early on in the post op recovery period. It will take 3-6 months for you to feel comfortable having implants in your body and for them to settle. This time allows for you to physically and psychologically adapt to your new body image. There are many variables that contribute to a breast augmentation's final result. Preop size and shape, IMF location, location of the implants and type of implant. Patients heal at different rates and each breast will sometimes heal at a different rate. Rest, relax, recover and heal. Please Express your concerns to your surgeon so he/she can examine you at this time. Then reassess final result at 6 months. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. Best of luck! Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon

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.