Breast Implants “Dropping” or “Settling” Is Not A Good Thing

Sep 23, 2011 by

Most women want breast implants for aesthetic reasons- for larger breasts, to solve drooping or sagging breasts or increase breast size to firm up some of the loose skin. The post augmentation look of the implants is key, along with safety this is the most important factor.

How can a doctor discuss the post augmentation aesthetic look of the implants if the implants will drop and move after the surgery? Does the doctor know how much they will drop? If so, why are there so many stories in various blog posts and online forums with unhappy patients whose breasts either didn’t “drop” and ride high on the chest, or whose breast “dropped” or settled low and now look like a rock in a sock?

Breast implant dropping is not a good thing, the doctor is forced to estimated the amount of repositioning that will occur when placing the implants.

One of the most common questions about breast implants is “how long before my breast implants drop”. Check out this answer, which seems to be a common answer, I found on another website:

For most women, breast implants rest a bit high for a short period after surgery, and then they drop into a more normal position. This usually takes a few weeks. The time it takes your breast implants to drop depends upon several factors, including the implant size, what size you were before your breast augmentation surgery, the implant surface type, implant placement, your muscle tone and whether you massage your breasts. Smooth breast implants drop faster than textured implants. If your implants are placed underneath the chest muscle, they will drop slower than if they are placed over the muscle. If you had very small breasts before, and get moderate to large implants, they will take longer to drop because of the tightness of your skin. Sometimes, one side will drop before the other side.

Some surgeons advise patients to push their breast implants down or massage them soon after surgery to encourage them to drop. If you are having problems, your surgeon may have you wear a wide elastic band around the top of your chest to help push your implants down.

If your implants still haven’t dropped within six to nine months, breast augmentation revision surgery may be necessary. Talk to your surgeon.

This answer- while not from a doctor- supports what I am discussing, how much will the implants move or drop? And when? And if there is an issue with the final position of the implants, a breast augmentation revision surgery will be needed. I would think the revision would be paid for by the patient? Seems a better option to try and place the implants where you want them to end up and not have to guess how much dropping or settling will take place.

It is good the answer mentioned the implant surface type- the ability of the implant surface to form a bond with the tissue is what prevents dropping or moving. This answer is correct in saying a smooth implant will drop faster than textured- there is no friction on the shell of the smooth implant to prevent it from dropping or moving. Textured implants offer more resistance and can drop or move more slowly than smooth, but the fact they *can* drop is still problematic- what if they don’t drop, what if they drop to much.

Polyurethane foam covered silicone gel implants do not drop or settle. This following is taken from a paper written by an Australian doctor that can be found here and discusses Polyurethane foam implants dropping and settling:

The learning curve for using these implants is not difficult as long as you know that these implants stay where they are put. They do not “settle” into the pocket. If they are too high the day after surgery they will remain so. Because smooth and textured implants often do “settle”, subconsciously we may tend to put them in slightly high to allow for this. When surgeons start using the foam if they are not made aware of this they may place the implants too high. However, if you know about it and sit the patient up before closing it should not be a problem. In fact I would argue that this is an advantage since it affords control and predictability of implant position to the surgeon.

Here is information from another website written by a doctor that describes how the adherence the the tissue prevents the dropping or settling:
The other important advantage of “Furry Brazilians” is that they have a “velcro-like” adherence to the pocket walls.  Accordingly, the implants should not move out of position, or rotate in the case of ‘tear drop’ shapes, as other implant types can. 
As Dr. Fleming mentions, a doctor must be trained on how to implant Polyurethane foam implants are it is not the same as smooth or textured implants, Polyurethane foam implants stay where they are put and have a higher friction coefficient when implanting. But the benefit is significant, a doctor can evaluate the placement of the implants during and after the breast implant surgery and know the position will not change. 
This seems a much better option than guess how much the implants will drop or settle and possibly having to perform a breast augmentation revision if the final result- 5-6 months later- is not the ideal position. 

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