How long will it take my breast implants to look normal? [Dan Zegzula, MD, Portland]

Dr. Zegzula (00:00):
Dan Zegzula. I'm a plastic surgeon, Portland, Oregon at the Portland Plastic Surgery Group.

Eva Sheie (00:06):
When do you see your breast augmentations back after surgery? How many times?

Dr. Zegzula (00:10):
We see all of our patients post-op day one. I usually don't see 'em that day, but the nurse will, and they're being checked for symmetry, make sure there's no unexpected swelling or bruising, answering any questions that they might have about their postoperative care. So that's postoperative day one with the nurse. And then at two weeks, I see my patients, look at their incisions, and again, just like the breast reduction patients, if they're doing well at two weeks, I let them doing some light exercise, some light cardio, some lightweight lifting, and then by four weeks they're running, by six weeks they're fully back in the gym and being active. And then we always see our patients, I make a strong point to see my patients at a year with my breast augmentation patients because I want to check their implants. And then after that year, then I see 'em at five years and then we start talking about screening their implants, and then I'll see 'em every two or three years after that until they're thinking about having their implants changed.

Eva Sheie (01:08):
When do they see their final results? How long does that take?

Dr. Zegzula (01:12):
Yeah. I think when they're above the muscle, they see their final results sooner. There's less swelling, there's less settling in. The whole drop and fluff phenomenon doesn't really happen when you're above the muscle. When you're under the muscle, that does happen. So I'd say, above the muscle you, you're definitely seeing your final results when you're three months out. Yeah, between three months and a year, you might get a little bit more settling of the implant, but not a lot. When it's under the muscle, probably have to add a couple of months to that. You're probably seeing your final result at four to six months, and then again, by the end of the year, maybe just another 10% of settling happens. Everybody's really settled in by a year, and it's hard to believe that it takes that long, but it really, it's a subtle thing after those first few months, it's a subtle settling and softening of the implants up to about a year.

Eva Sheie (02:06):
What does drop and fluff actually mean?

Dr. Zegzula (02:08):
Well, it's the way the breast looks it. It's a little bit more complicated to know exactly what's happening inside the breast, but many times, especially when the breast implants are under the muscle, there's a lot of swelling and fullness in the upper pole of the breast, that is from the nipple up. Things are a little fuller than would look natural. Sometimes patients like all of that fullness, but the lower part of their breast is somewhat underfilled as the implant looks like it's sitting too high. Some of that is implant position, I think, but a lot of that is swelling in the muscle. And then as that swelling goes down and then the skin between the nipple and the fold that is the lower part of the breast, that skin starts to stretch and then the implant settles into its final pocket and looks more natural, it usually gets softer at the same time, sometimes more comfortable as the swelling goes down. And that's the drop in fluff phenomenon, and it usually does take a few months.

Eva Sheie (03:03):
I always wondered. Thank you.

Dr. Zegzula (03:05):
Yeah, and I tell my patients, don't buy too many bras until that is all happened, because they're just not going to fit right. If you buy your bras too soon and then the dropping and the fluffing happens, then they just might not fit the way they did before.

Eva Sheie (03:18):
That's good advice. On this podcast, we bring you directly to the doctors who are where before meets after. Links to our guest's website and contact info are in your show notes. Follow us on Instagram @wherebeforemeetsafter. Where Before Meets After is a production of The Axis, the podcast agency for aesthetics, theaxis.io.