Drop & Fluff: Why Implants Settle

The term “drop and fluff” refers to breast implants and is familiar to most of my breast augmentation patients here in the Phoenix area. It is commonly used on breast implant chat sites and refers to the process breasts undergo in the first few months after augmentation surgery. While this term may sound humorous, it is actually a pretty good description of the process.

Why Do Implants Look High and Tight at First?

Immediately after getting breast augmentation, patients experience an inflammatory process that causes swelling of the tissues combined with tightening of the chest muscles. This can give the breasts a tight appearance that may include:

  • A “humpy” appearance of the upper breast
  • A flat appearance at the outer breast
  • Implants looking smaller because of constricted the tissues

Furthermore, swelling between the breasts can fill in the cleavage area, also making the breasts look smaller and wider apart than they actually are.

What Happens When Implants Drop and Fluff?

Over time, the swelling resolves, the tissues loosen up, and the shape of the implant starts to exert itself on the overlying tissues. As a result, the implants settle into a lower, more aesthetically pleasing position on the chest. They appear softer and rounder, and they look larger and closer together. Hence, “drop” (settle lower) and “fluff” (round out and look fuller).

How Long Does It Take for Implants to Settle?

Different factors affect the speed of this process, but in general, patients should expect 6 weeks to 3 months for a more “final” appearance, and in reality, breasts can continue to look more natural over many months. Tighter skin before surgery (such as with a younger patient with no prior pregnancies or breast surgery) will take longer to expand than looser skin. Larger implants generally take longer to settle than smaller implants, as the skin has to stretch more. Finally, textured implants take longer to settle than smooth implants as they are more stable and do not require postoperative breast massage.

The bottom line is that breast augmentation is an evolving process and patients need to be, well, patient with their results. I sometimes call it the gift that keeps on giving as implants generally become more attractive with each week after surgery. It is important to understand this before surgery so you allow your tissue the time it needs to accommodate your new implants. Learn more about what to expect during recovery after breast augmentation in this previous blog post.

I encourage you to visit our online gallery of breast augmentation before & after photos to see our beautiful, natural-looking results. If you’re interested in learning more about breast augmentation, request a consultation to get personalized answers to all your questions.

 

Published: 4/4/14, Updated: 9/30/2020

22 Responses to Drop & Fluff: Why Implants Settle

  • leonna speirs says:

    Hi, thank you for the information, it was really helpful, I am now 9 months post op but my breasts have yet to drop and fluff, could you give me any information to help this process
    Regards
    Leonna

  • Jan Thompson says:

    I’m 11 weeks post op and my breasts are yet to drop and fluff. My PS has told me that I may need a revision after 9 months if it doesn’t drop any further. Is there anything that I can do to help with the dropping and fluff.

    • Dr. Robert Cohen says:

      The reasons for why implants may not drop are varied and depend on surgical techniques, what type of implants you have, whether they are over or under the muscle, the tightness of your natural tissues, etc. Occasionally revision surgery is needed to lower implants that do not settle as much as expected. The best advice is to see your original surgeon again and see if he or she advises downward massage, physical therapy, or any other maneuvers to improve implant position based on knowledge of you, the implants, and the exact surgery that was performed. Best of luck!

    • Robert Cohen says:

      It’s hard to answer this type of question when I didn’t do the surgery, but in general breast implants will take on a fuller look as the skin has a chance to expand over time. This process can take a few months so be patient. If you have any questions or concerns the best thing to do is contact the plastic surgeon that performed your surgery.

  • Stacy Howell says:

    Teng, I was a small C cup before and wanted DD. I am 3 weeks post op and feel like I got a full C cup. I got 445 in one and 425 in the other. Hope they get bigger. This definitely wasnt worth the money I paid.

    • Blog Admin says:

      Hi Clarissa!
      As time goes on, breast implants settle and give a more natural appearance. What registers as “too big” is often just excess upper pole fullness from swelling and the implants riding high in the early postop period. Be patient and I would guess that over time, as the implants settle and you get used to having them, you will feel much more comfortable with your size.

  • Shar says:

    Hi I was a 34b and I got a 450cc I got them done last week and am so disappointed they look so small I have spent years saving up my surgan said I would go to a size e but I tried my normal bra on yesterday and I am only a c 5 grand for a cup size up 🙁 I am hoping they will get bigger but I carnt see them shooting up to a size e from the size they are at the moment

    • Blog Admin says:

      Implants often look tight at first and “fluff out” over time. 450cc is a good size implant so I would guess they will look fuller once your skin has a chance to expand. Obviously that’s my best guess since you’re not my patient. If you have concerns you should address them with your surgeon- I’m sure he or she would want to discuss that with you directly!

  • Gwen says:

    I’m 3 weeks post op and my implants have not dropped even the slightest bit, they are still very high onto my chest and the lower breast is still very empty and the top is still pretty tight, should I be worried if at this point I have not seen any difference?

    • scp-admin says:

      In general I would expect implants to show some degree of softening and settling by 3 weeks after surgery, although there can be variations on this based on the anatomy and implant size and style. If you don’t feel like you have made any progress, I would recommend contacting your plastic surgeon to see what he or she suggests at this point (such as downward massage, the use of a compression strap, etc). – Dr. Robert Cohen

  • Edith says:

    I know this is repetitive, but when the breast fluff and drop. Do they gain more volume and aesthetically look fuller and bigger?

    • scp-admin says:

      With the “drop and fluff” phenomenon, there isn’t a true volume gain as the volume is already there. What happens is the skin and soft tissues initially compress the implants, making them look smaller and tighter, and as the skin and soft tissues relax, the breast takes on a softer and fuller appearance.

  • Amanda says:

    What type of time difference is normal in dropping between breast? I received subpectoral implants and I am 3 weeks post op today. My left side (non dominant side) has a 415 cc silicone implant while my right side (dominant) has 450 cc silicone implant. My left side has seemed to drop a significant amount and looks much fuller for the past week and a half or more. Is it normal for my right side to still seem so much higher and tighter than my left? And how long is too long for my right to be high and tight when my left is low and soft/full?

    • scp-admin says:

      The time for each breast to drop in will vary with different patients. It’s not unusual to see some difference at 3 weeks but for patients having issues like yours I will usually have them start some downward massage on the high breast side to help speed things along. Occasionally if I am concerned about excessively tight scar tissue I will use Singulair (an asthma medicine) that is a smooth muscle relaxer and has shown some evidence of helping loosen capsules (the scar tissue that forms around implants). Each patient should speak with their original surgeon about what to do as they will know what was done surgically and will have their own protocols based on that. – Dr. Robert Cohen

  • Kara says:

    I’m feeling the same way. I have 520 cc’s and I don’t think they look big at all. I’m 2 weeks post op. So hope when they drop they will really fluff out too!! Went from an a cup to the 520 cc’s and again don’t seem big at all ? is there anything I can put on my incision? My right side is a little sore on incision part and looks a little irritated. Didn’t know if I could put a triple antibiotic ointment on it or not just to help it.

    • scp-admin says:

      Breast implants, especially if the skin envelope is tight, will look fuller over time as the soft tissues relax and expand with the presence of the implant. As far as incisional treatment, every patient should speak with their original surgeon as different surgeons have different preferences regarding that. – Dr. Robert Cohen

  • Jessica K says:

    I just got my breast done 2 and a half weeks ago, I’m 5’7 and 162 lbs, with broad shoulders. I started as an A cup and my doctor put in 520CC. He told me they would come out to be in between a D and Double DD. But they look like B’s 😢, I know it’s still early to tell but side view it looks like I have no boobs !

    • scp-admin says:

      Breasts can expand dramatically over the first 3 months or so. Because of this fact, I would advise you not to judge your results now as the breasts will likely get bigger as the muscles and soft tissues relax. 520cc is a larger implant on someone of your height and weight so I would expect that you will look much fuller over time. If after 6 months you still feel undersized, you can discuss a relatively simple implant exchange and upsizing with your surgeon but I doubt that will be necessary. – Dr. Robert Cohen

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