Breast Implant Settling: What to Expect and When

settling of breast implants after surgery

Breast augmentation surgery improves the shape, size, and symmetry of the breasts. This procedure is an excellent option for addressing multiple aesthetic concerns, such as changes in breast fullness related to breastfeeding, menopause, or weight loss. Breast augmentation can also be used to enhance naturally small breasts, giving the patient a more hourglass-like figure.

As is the case with many plastic surgeries, the results of breast augmentation develop over time. Though the initial healing period that follows this procedure is typically brief (most patients can return to work seven to ten days after having breast augmentation), the body takes between three to six months to fully adjust to the presence of implants. During this time, the implants shift into a more natural position and the tissue around them expands, a process that’s often referred to as “dropping and fluffing.”

If you’re thinking of having breast augmentation, knowing what to expect after surgery can help put your mind at ease. Patients who aren’t familiar with the settling period that follows implant placement often worry that they’ll need revision surgery or implant removal when this is seldom the case. Most breast augmentations performed by experienced board-certified plastic surgeons yield beautiful, natural-looking results; in many cases, these results just take time.

Why do Breast Implants Need Time to Drop?

Modern breast augmentation methods contribute to the gradual nature of breast augmentation results. In the past, plastic surgeons placed breast implants above the chest muscles, so that they sat just below the patient’s skin and breast tissue. Today, most plastic surgeons prefer to place implants partially below the pectoral muscles. Using this “under the muscle” placement technique produces a more natural-looking breast slope and minimizes the risk of capsular contracture. However, it also means that breast implants must be placed higher on the chest wall during surgery, and muscle tissue takes longer to relax than skin or fatty tissue. These factors add to the time it takes for implants to fully settle into the breast pocket.

Most breast implants, regardless of their shape or filling material, require about the same amount of time to settle, but there are some exceptions to this rule. Large implants usually settle a bit faster than small implants, simply because they weigh more. Textured implants are associated with a slightly longer settling time than smooth implants because their rougher surface holds them in place more firmly.

What to Expect as Your Implants Settle

Not everyone needs to wait four to six months for dropping and fluffing to occur; most women experience complete results after just three months. How much time your breast implants will need to settle depends on several different factors, including the density of your breast tissue, the firmness of your skin, and the reaction of your muscles to the presence of implants. (Some women’s pectoral muscles tighten more than others.) Younger women may experience longer settling periods than older women because of their tighter skin or due to more dense breast tissue. As such, there’s generally no need to worry if your breasts are settling more quickly or more slowly than you anticipated; your body is just healing at its own pace.

Initially, most patients notice that their breasts look much higher, rounder, and somewhat larger than they expected. Postoperative swelling will make your breasts seem fuller than they are for up to four weeks after you have surgery. Your breasts may also look slightly asymmetrical immediately after surgery, but they should even out as healing progresses. If one of your breasts is naturally larger than the other, the implant inside the larger breast will probably drop more rapidly because there’s more skin to accommodate it. After the skin of your smaller breast stretches, both breasts should sit at the same elevation and be roughly the same size.

Breast implants start to drop within days of surgery, but swelling can make these changes difficult to see. By the second or third week after your surgery, however, you should be able to see your implants sitting lower on your chest. By week six, most women’s implants approach their final position (resting in the lower half of each breast). At this point, the implants have largely “dropped” into place. You’ll know your implants have dropped when you can subtly feel the lower edge of each implant near your inframammary fold (the crease below each breast).

If one or both of your implants don’t appear to have dropped at all by the six-week mark, you should visit Dr. Silverton for follow-up care. In rare cases, a lack of settling by six weeks can indicate that the patient is developing capsular contracture, a hardening of the tissue around the implant. Capsular contracture is easier to treat if it’s caught early, so don’t hesitate to have your breasts examined if you think something is amiss.

Between six weeks and three months after breast augmentation surgery, the capsule of tissue that surrounds each implant becomes more robust. Blood flow around the implants improves during this period, increasing sensation and fullness. Fatty tissue adapts to the contours of each implant, providing cover and support, and the skin continues to stretch and relax. This process is called “fluffing” because the breasts take on a softer look.

For up to six months after surgery, you may continue to notice more subtle improvements in the shape and position of your breasts. By this stage, your scars will have mostly faded, too. After one year, your scars should become smooth and supple, making them more difficult to distinguish from the skin around them.

If you have any concerns about your results, you should feel free to mention them during one of your follow-up appointments. Dr. Silverton will help you track your progress so that you have more insight into when you can expect your final results. Some women also choose to track their progress with pictures as soon as they have their bandages removed. Doing this can be reassuring because it’s easy to overlook gradual physical changes without a visual reference.

5 Ways to Ensure Optimal Breast Augmentation Results

Though you can’t significantly speed up the process of dropping and fluffing, there are several steps you can take to ensure that your breasts heal optimally. Practicing proper aftercare will maintain the symmetry of your breasts and minimize the risk of certain issues, such as scarring and capsular contracture. Though Dr. Silverton will provide you with detailed aftercare instructions before you have surgery, reviewing the tips below can help you prepare for your recovery in advance:

  1. Wear a supportive surgical bra after breast augmentation.

Before you have surgery, you’ll be provided with a special bra that’s designed to support your breasts while they heal. Wearing this bra as directed is essential: Don’t avoid wearing a bra with the hope that your implants will drop faster. Not wearing a bra after breast augmentation only increases discomfort, the risk of capsular contracture, and uneven healing. Wearing a surgical bra is necessary to keep your breast implants properly aligned as they drop.

At first, you’ll need to wear your supportive surgical bra 24 hours a day. Surgical bras are designed with an open front, so your bra won’t tug or squeeze your breasts as you move. These bras are also designed to be comfortable to sleep in. Two weeks after your surgery, you may be able to go bra-free at night, but you should talk to your surgeon before you make any changes.

  1. Use scar tape and scar gel to help your incisions heal.

Your surgeon may place silicone gel sheets over your incisions to help them heal more quickly. Using these sheets greatly reduces the risk of hypertrophic scarring (the development of thickened, raised scar tissue). They also prevent bacterial contamination that causes infection.

After your incisions have closed completely, you can use medical-grade healing gel to improve the tone and texture of your scars. For best results, this gel should be used for at least 60 to 90 days.

  1. Avoid unnecessary stretching and lifting.

Most people know they should avoid vigorous exercise and heavy lifting for at least three to four weeks after surgery. However, it’s important to understand that even moderate lifting, stretching, and bending can increase your risk of capsular contracture. Lifting anything heavier than a large cup of coffee can cause the pockets of tissue around each implant to tear, which allows bacteria to infiltrate the capsule. This risk should diminish a few weeks after surgery, but you should still talk to your surgeon before you do anything strenuous.

Choosing the right clothing to wear while you recover is also important. Ideally, you should wear loose tops that button up the front. Wearing loose clothing allows for easy removal without the need for raising your arms, reducing stress on the capsules around your implants.

  1. If advised by your surgeon, gently massage your breasts while they heal.

In some cases, very gently massaging the breasts can improve circulation around the implants and help them settle into their final position. However, it’s important to only use massage techniques that are recommended by your surgeon, as improper or overly vigorous massaging can cause problems during healing. Likewise, not everyone should use massage; patients who have combined breast lift and augmentation surgery, for example, should avoid massaging their breasts.

  1. Maintain a healthy lifestyle for at least a month after you have surgery.

Eating a light, nutritious diet, getting enough sleep, and avoiding bad habits like smoking and consuming alcohol can expedite healing and help you achieve flawless results. We recommend stocking up on soft yet healthy foods, like applesauce, smoothies, and bananas, before you have surgery. This way, they’ll be readily available as soon as you return home.

After healing is complete, you should continue to provide your breasts with adequate support. Wear a bra during the day and use a high-quality sports bra when you exercise. The idea that breast implants can’t sag is an urban myth: Though augmented breasts do retain their shape better than natural breasts over the long term, all breasts can sag if they aren’t properly cared for.

Arrange a Breast Augmentation Consultation

Having breast augmentation requires patience and commitment, but for most patients, the results are well worth the wait. Breast augmentation can lift and fill out breasts that have become flat over time, or enhance naturally small breasts in a way that’s graceful and flattering to your figure. To learn more about this procedure, contact board-certified plastic surgeon Dr. John S. Silverton to arrange a consultation in Stockton, California. When you visit our office, Dr. Silverton will personally answer any questions you have about breast augmentation and help you explore your options.