Implant "Drop & Fluff" Process Following Breast Augmentation Surgery

The Drop & Fluff Process

Although you will be anxious to see your results of your breast augmentation procedure immediately after surgery, the final results will only appear 6 months post surgery, at the end of a process called "drop & fluff". During this process breast and chest tissues undergo a period of stretching until they loosen up and allow the implants to finally settle in their pocket and have a more natural feel.

What happens when implants drop and fluff?

Directly after your procedure, you may notice that your breasts feel firm, sit high on the chest and have an unnaturally looking fuller upper pole. "Dropping" and "fluffing" is the process of your breast implants settling into their permanent place after breast augmentation.

“Dropping” refers to implant settling

Immediately after an augmentation, breasts look very round and sit high on the chest; eventually, they take on more of a teardrop shape. Attribute this to good old-fashioned gravity. As time goes on, the bottom of the breast implant will settle more toward the bottom of the breast area. It’s not, necessarily, that the implant itself is moving downward significantly—though it may drop a centimetre or two—but more so that it’s being redistributed and settling into its final position.

The changes happening to the surrounding tissue also play a role, as does the swelling that inevitably occurs post-surgery. “After a breast augmentation, there’s a lot of swelling on the upper side of the chest, where the chest wall turns into the breast. Because that swelling is higher up on the breast, as it subsides, it creates the illusion that the implant has dropped.

“Fluffing” refers to skin expanding

No matter whether you put a breast implant under or over the muscle, there’s a lot of expansion and stretching of both the tissue and the overlying skin, after the fact, as well as scar tissue that’s formed around the implant. This tissue is tight and hard because it’s being pulled taut, and it takes time for the skin to stretch out and soften. As it expands, you get not only a more convex appearance, but the breast also begins to feel softer. (It’s worth mentioning that the aforementioned swelling is also part of the reason that breasts feel so hard post-surgery.)

“Dropping & fluffing” is an ongoing process

The breasts you see one week after surgery are not indicative of what your end result is going to be. So how long does the “drop and fluff” take? About 3 to 6 months is average, though it takes a full year to really get the final look. And keep in mind that changes are ongoing throughout this time. A patient is going to see a difference from week to week, it’s just that the complete process takes months.

Factors such as how big your implants are, your natural breast size, and whether the implant is placed under the muscle all play a role in how long the settling/healing process lasts. It typically takes longer for someone who is naturally smaller-framed and didn’t have large breasts to begin with than it would for someone with larger breasts or who is postpartum, with breast tissue that’s already been stretched out. As a general rule of thumb, the bigger the implant, the longer the dropping and fluffing period. Implants that are placed under the muscle also take longer, because they have to push against the muscle and force both it and the tissue to stretch.

Some asymmetry is normal

Augmented or natural, breasts are sisters, not twins. “While the ‘drop and fluff’ is a normal part of the healing process, the exact reaction can differ from breast to breast. Breasts progress at different rates. You really have to think of it as two separate surgeries, with two different healing processes. Point being, don’t be alarmed if your breasts are slightly asymmetrical during this initial three- to six-month period.

This initial unnatural appearance and possible implant asymmetry can be quite concerning for patients who are not aware of this aspect of the recovery process. It is also not uncommon for the implants to drop in different times and look different until this process is completed.

You should be concerned, however, if the asymmetry is extremely noticeable—that is, if one breast is dropping and fluffing nicely and the other one isn’t changing at all. Similarly, see your doctor if one of your (or both) breasts is becoming harder and firmer rather than softer. Both situations can indicate capsular contracture, a complication in which excess scar tissue forms around the implant, likely due to some type of bacteria.

If there’s no capsular contracture or other complication and it’s just that the breasts are progressing at very different rates, there are other things your doctor may advise you to do. This includes options such as massage or wearing a compressive band, to help speed up the process of the implant settling into its final spot.

When the implants finally drop, the upper chest fullness is reduced and the lower pole is filled, creating a more natural upper breast “slope”, while the nipple is lifted in a higher position.

How long do implants take to drop and fluff?

Initial swelling and bruising should subside in one to two weeks after getting breast implants. With this, your muscles should begin to relax, allowing your implants to gradually settle and soften. The entire drop and fluff process can take 3 to 6 months to complete.

Factors that affect the speed of the drop & fluff process

Keep in mind that everyone's breast augmentation recovery will happen at a different pace. How quickly your implants settle depends on various factors:

• Skin Laxity – If you have good skin elasticity, it will take some time for the tissues to stretch. However, your implants will drop and fluff more quickly if your breast tissue has stretched due to pregnancy, weight fluctuations, or previous breast surgery.

• Implant Size – Larger implants will drop faster due to gravity. But another thing to consider is that having larger implants will require your tissue to stretch more, which will take time.

• Implant Surface – There are textured and smooth implants. A textured implant’s friction with your breast tissue will slow the drop.

• Natural Breast Size – If your natural breasts are small in size and you have good skin elasticity, the breast tissue will be tightly wrapped around the implant, which will make it go down slower.

• Implant Placement – If the implant is placed over the pectoral muscle, it will drop and fluff more quickly because there would be no pressure from the muscle. There would be no need for the implant to stretch the muscle tissue and the breast tissue.

• Muscle Strength – If the implant is placed under the muscle, its strength will also make a difference. If you’re physically active, you’ll have enhanced muscle strength, which can make it even more difficult to stretch it.

Keeping these factors in mind, just remember that dropping and fluffing can take place at different paces for different people.

The drop & fluff timeline

It takes 3-6 months for the breast implants to drop & fluff. This processes can take up to 6-9 months if the breasts are too small or tubular. Following is a timeline of dropping and fluffing after augmentation surgery:

1 Week Post Op

Your breasts will feel tight and sore because the tissues and muscles need to stretch to make space for the implants. Moreover, you’ll have swelling, asymmetry, pain, bruising, and numbness at this stage. There may also be nerve pain, which usually feels “sharp.”

6 Weeks Post Op

Most of the swelling will subside 6 weeks after surgery. It can make the breasts look smaller, and many patients feel that they should have gone bigger at this stage. However, the dropping and fluffing process is still ongoing. Once the implants settle in the lower half of the breasts, it will make them look bigger.

3 to 6 Months Post Op

At this stage, the bottom of your breasts will become rounder and more noticeable. They will also round out more prominently on the sides. Your breasts will be close to their final shape (unless their size is too small), but you should wait till the 12th month.

Do breast implants get bigger when they drop and fluff?

Your breast implants may appear to be bigger or fuller once they've dropped to a lower, more natural-looking position on your chest and "fluffed" into a rounder and softer shape. Changes in the size or shape of your new breasts after augmentation can also occur as swelling and tightness subside.

You might notice that the appearance of your new implants changes several times before your final results settle in. This is normal and nothing to worry about. Before you spring for a new wardrobe, though, give your breasts several months to settle into place and for their size and shape to stop adjusting.

How can you make your implants drop faster?

The rate at which breast implants will drop and fluff varies from person to person and will depend on how quickly your body begins to heal after your breast enhancement procedure. The most important thing you can do to help the healing and drop and fluff process go smoothly is to follow your plastic surgeon's aftercare instructions as closely as possible.

While there is little you can do to make your implants drop and fluff faster, following your plastic surgeon's recovery guidelines will help to optimise your body's natural healing process and minimise the risk of complications.

Some examples of breast augmentation recovery guidelines you may be asked to follow include:

• Avoiding strenuous physical activity until cleared by your plastic surgeon

• Wearing a compression garment

• Taking proper care of incisions

• Avoiding tobacco use and excessive alcohol consumption

• Attending scheduled follow-up appointments

What happens if your implants don't drop?

If your breast implants are taking longer than expected to settle into place, don't panic. There are several reasons why this process may take longer.

Smaller, lighter implants, for example, may take longer than heavier implants to drop and fluff, as heavier implants have extra help from gravity to do the trick. Similarly, if you have textured breast implants, you may see a more gradual drop and fluff process than with smooth implants, since textured implants will have more friction against the adjacent tissue.

In most cases, breast implants will drop and fluff – whether gradually or more dramatically – over the course of three to six months after your procedure.

If this does not appear to be happening or if you are experiencing any problems such as unusual pain, bleeding or swelling that does not go down or is getting worse, don't hesitate to contact your plastic surgeon to rule out the possibility of complications.