I Am Wondering if the Size of my Breasts Will Change As the Implants Soften and Settle?

Question

I am four weeks post-op with HP 350cc gummy silicone. I am worried as the implants soften that I will lose a cup size and be a b. I was a 32A (buy couldn't fill the whole bra cup) pre-op. I workout and have quite developed chest muscles which is why I got the surgery because I basically had all muscle and bottom breast tissue. Initially I was a D post off but as the swelling goes down I am C. I don't want to get any smaller and am worried I will. Any advice? I know, full results in a year! : )

Richard H. Tholen, MD, FACS · Answer

By 4 weeks post-op, the majority of your surgical swelling has diminished, and only subtle additional loss in volume can be expected to occur. I'm actually surprised that you have lost almost a cup size with initial swelling resolution, as most of my patients have little swelling, almost no bruising, and actually improve in projection as tissues stretch and implants settle (and yes, I place implants in the submuscular position most frequently). Careful surgery and precise hemostasis is better than a drain or tight surgical bra, and leads to much less post-operative swelling, bruising (and lower capsular contracture rates) overall.

	350cc will generally add almost a cup and a half size to whatever breast volume you started with, so by your size description, you should end up at a small C-cup in size, but that depends so much more on the bra manufacturer than anything else!

	If you have true style 410 "gummy bear" implants, these are teardrop-shaped, textured implants that will not drop or settle much more (they "adhere" to your tissues and do not move much). You will note subtle changes for 6-12 months in breast softness, sensation, and scar maturation, but volume or size-wise you pretty much will have long-term what you have right now. If you have smooth round cohesive gel implants, these are not actual "gummy bear" implants, and these can be expected to soften and drop a bit more as time goes by. I hope this helps! Best wishes! Dr. Tholen

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question, and your photo.  Cup size can be a funny thing.  It's mostly based on projection.  It can also depend on how much breast tissue you had to begin with.  Figuring out the cc's is often based on your base width, (how wide your breast is).  Some Plastic Surgeons will uses sizers at time of surgery, but we are all different.  There used to be standardization, but that went away.  It can depend on what style of bra you wear.  You are early in your post operative course.  They usually will get to their final position in 6 to 12 months.  One will usually drop faster than the other, and the shape may go through various changes.  Please follow your Board Certified Plastic Surgeon's post op instructions. For example; we like message, but some surgeons will have you wait, or do it in a specific manner. Please let them know your thoughts and concerns.   
Jeffrey J. Roth, M.D., F.A.C.S.
Board Certified Plastic Surgeon

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).

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Breast Size will difinitely go down after augmentation due to a decrease in the swelling.  Shape will also change after implants settle.  Healing after any surgery differs from patient to patient.  Time will tell if on your final size. 

	Dr. ES

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I Am Wondering if the Size of my Breasts Will Change As the Implants Soften and Settle?

Answers (9)

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