While “fluffing” may sound indecent it is actually part of the breast augmentation process and refers to the migration of the implant to fill the implant pocket. The skin covering the breast implant stretches and / or the muscles relax. In sync with this stretch and relaxation the implant will slowly shift down or the "drop" happens. After the "drop", the implant will fill out the lower breast to create more volume in the lower pole.
During this time we ask patients to "trust the process" and realize their final result is not immediate. Slowly over time your breast will take their natural shape.
For a total sub-muscular or dual plane breast implant pockets, you will notice in before and after photos and on yourself that for the first few weeks the implants will be high on your chest. This is normal and caused from the muscles tightening against your chest.
Everyone is different and everyone's anatomy is slightly different. This causes some variations on the timeline for breast implant progression which include pre-operative pectoral tightness, firm / soft breast tissue, skin laxity, and implant size. To help you control the process, your plastic surgeon may recommend a breast strap (helps push them down), breast stretches to target a tight pectoral muscle, or breast massages. Always talk to your plastic surgeon for their recommendations before proceeding.
Typically most patients have noticed their implants settling into their final position 4-6 months. Normally one breast will drop more quickly than the other leading to some short term asymmetry. You will be able to tell when the implant is in the final position when you feel the implant in your inframammary fold or your breast fold at the base of your breasts.
Below is a quick timeline of what to expect:
You will feel very sore and tight the first week. For the first two weeks minimal reaching/pulling with the arms, and less than 10 pounds lifting of weight. Your plastic surgeon should recommend a post-operative bra for support after surgery.
You will need pain medication and will notice bruising, swelling, nipple tenderness, etc.
For the next two weeks no more than 30 pounds lifting, but during this time you may reach and pull with the arms. In total, there will be 4 weeks of no intense exercise and you will be in a bra 24/7 except for showering. After these 4 weeks, most patients may begin regular exercise as tolerated.
By week four, most of the pain, swelling, and bruising will have subsided. Most patients feel well enough to return to work after the first two weeks but your plastic surgeon should be kept posted on your recovery journey and clear you to return to work.
Over this period the final shape of your breasts will form, and by the end of month three, the implants should be fully settled. It’s a long process, but the results are worth it so be patient with your body and let it heal.