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Breast augmentation is an operation that makes an immediate and dramatic change. Because of the implant’s expansive effect, there are certain alterations in the overlying skin of the breast mound that most patients don’t think about or aren’t aware of. These changes frequently result in phone calls and concern during the first month after surgery.

The first thing that one will notice right after surgery is the breasts are very firm and stiff. They will feel unnatural and not what you expected breast implants to feel like. This is the result of swelling and immediate expansion of the skin by the underlying implant. The skin will simply need some time to relax. It will take at least a month before the skin starts to relax and feel softer. It will likely take up to three months after surgery until the breasts feel normal and you forget about the fact that you have implants. What once felt like ‘rocks’ on your chest will eventually become a naturally feeling and looking breast.

As part of this immediate skin expansion effect is that the shape of the breasts will initially look very round like balls on your chest. They will usually also look somewhat high with a very full upper pole of the breast. This is less so if you had some sagging before surgery and will be particularly so if you had fairly tight chest skin before. While some patients want a more rounded breast look, this is exactly what many other patients do not want and fear. As the swelling subsides and the skin begins to relax, this round look will start to become less so. It takes the skin on the bottom side of the breast to relax and stretch out for the implant to settle into a more natural lower position. The use of banding (strap across the top of the breast), implant massage, and sleeping on oneâ’s stomach can all help this process move along sooner.

Nipple sensation after surgery is often temporarily altered. Usually the nipple will feel hypersensitive and may cause undesireable sensations even if lightly brushed or touched. This too sensitive nipple almost always settles down in the first month after surgery and returns to normal feeling. Less commonly, the nipple may feel completely or partially numb and it may take up to several months for full feeling to return.

Occasionally, patients report the sensation of fluid or sloshing around the breasts in the first seven to ten days after surgery. This is normal as is the result of residual irrigation fluid used to wash out the breast pockets prior to incision closure. As the fluid is absorbed, this sensation will go away.

As I tell my Indianapolis breast augmentation patients, it is important to remember that the chest skin and tissues will take some time to adapt to the new implant. Since the implant is synthetic and can not relax or give over time, the overlying skin must eventually do so. Tiny nerves that control the feeling on the bottom side of the implant are temporarily severed and must regrow after which all your breast feeling will go back to normal. This adaptation and healing process takes time and one must not judge the results of breast augmentation surgery until this phase of recovery is complete.

Barry L. Eppley, M.D., D.M.D.

Indianapolis, Indiana

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