The process of 'drop and fluff' - how implants settle following breast augmentation

breast augmentation implants

The breasts undergo significant changes during the first few months after breast implant surgery commonly referred to as a period of ‘settling’. Early on, the breasts often look and feel unnatural – the implants sit high on the chest, especially when placed partly under the muscle (submuscular or dual plane), and feel hard. Although it can be disconcerting, this is normal. 

As the swelling resolves and the tissues loosen, the implants ‘drop’ into a lower position on the chest filling out the lower pole of the breast. This has two effects on breast appearance, which breasts begin to look and feel more natural with a full lower pole (‘fluff’) and smooth take off from the upper chest. Secondly, the nipples begin to project forwards or even upwards as more volume fills out the lower pole of the breast. 

The length of time it takes for the implants to settle varies from patient to patient from a matter of a few weeks to several months and is often different in each breast. The process tends to take longer with larger implants, patients with minimal loose skin and implants placed beneath the pectoral muscle (submusclular or dual plane). During this early period, I often see my patients regularly to ensure everything is progressing normally and to reassure them.

Preparing for a Breast Augmentation Consultation

It is important to get the most out of your breast augmentation consultation by preparing beforehand. It is a chance to meet with your plastic surgeon and decide whether he or she is the right person to help you achieve your goals and someone you can trust and be confident in.

breast augmentation

The consultation typically lasts 45 minutes if done properly. Here are a few things to think about:

Beforehand:
•    Learn about the procedure - implant insertion/placement techniques and breast implant types. This information will help you get the most out of your consultation and help you make informed choices. It is always best if the patient is involved in the decision making process!  
•    Check the credentials of your surgeon . In the UK, it is best to see a fully accredited Plastic Surgeon who is a member of either BAAPS (British Association of Aesthetic Surgeons) or BAPRAS (British Assoication of Plastic Reconstructive and Aesthetic Surgeons). Be aware that some ‘cosmetic’ surgeons may offer this procedure but are not trained in Plastic Surgery! 

What to bring to the consultation
•    A list of questions
•    Goal photos – this is important to guide expectations - as what one patient thinks of as a ‘natural’ look may in fact be overinflated and fake-looking to another! My special interest is in delivering natural, proportional and beautiful breasts but some surgeons specialise in very large implants!
•    A spouse, family member or friend for support – someone to help remember what has been said (there is often a lot of detail to digest) and to help advise.

What to expect during the consultation
•    Questions about any medical illnesses and medication you take.
•    An examination of the breasts with a chaperone breast (always) – the measurements help determine what the best range of implant shapes/ sizes are for your particular frame and goals.
•    A trial of implant sizers – trying on different sized implants in your ‘goal bra’ (provided by the surgeon). This helps refine decisions about implant selection. It is helpful to bring eg a top to get a feel for how the chosen implant size looks in your natural clothing. 
•    A detailed discussion about the best surgical plan in your situation including risks and complications.
•    A chance to review the surgeon’s portfolio of before and after photos. Ask about patients with a similar frame/ stature to yourself.

Finally, if you are keen to proceed, ask to meet up again before surgery to go through the details of the procedure and sizing again.