By Fadi Nukta, MD

Every year, countless women make the transformative decision to undergo breast augmentation for various reasons, from improved appearance to increased self-esteem. But what happens when those implants age or change over time? One crucial part of the process is helping patients understand implant dropping, which is the natural descent of implants into a more natural position during postoperative healing. Why does it happen, and what are the treatment options? There are a few points to note.

What’s causing a patient’s implants to drop?

For many patients, it can be quite a shock when they look in the mirror and realize that their implants have dropped a bit. There are a variety of reasons why this might happen, including:

  • Surgical technique and placement. Implants can be placed either sub-glandularly (above the muscle) or sub-muscularly (beneath the muscle). The latter often results from the initial high positioning of implants, leading to a more noticeable dropping as the muscles relax and accommodate the new addition. Additionally, the incision location and size can also impact how and when your implants drop. 
  • The weight of the implant. When it comes to deciding on the size and weight of the patient’s implant, it’s important to keep in mind that a heavier implant may cause more significant dropping. Lighter implants are less likely to drift down as much, so selecting an appropriate size for the body type is essential to avoid any major dropping. Discuss this with your patient, as the overall size can affect how far the implant descends eventually. 
  • The texture of the implant. Textured implants are designed to adhere to the body’s tissues and are thus less likely to drop compared to smooth implants. However, these implants come with risks, such as the potential for bacterial contamination and a rare form of cancer known as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
  • Patient-related factors. Skin elasticity, quality of breast tissue, and weight fluctuations can also significantly impact the degree of implant dropping. Patients with less skin elasticity or thinner breast tissue might experience a more noticeable dropping. During the patient’s initial visit, their plastic surgeon should perform a physical exam, where many of these factors will be addressed. 

Combatting Implant Dropping

It can be frustrating when implants begin to drop, but there are ways to combat this issue. They include:

  1. Selecting the right implant. At the heart of a successful breast augmentation is selecting an implant that fits the patient’s unique anatomy and desired outcome. With careful consideration of factors such as body type, lifestyle, and aesthetic goals, you and the patient can ensure the implant will stay secure over time.
  2. The importance of surgical technique and placement. To reduce the risk of dropping implants or other unwanted complications, it’s essential that precise surgical techniques be employed during placement. Every patient requires individualized care, so their chosen approach best suits their needs and expectations from surgery. 
  3. The internal mesh bra. For those looking for additional support after getting larger implants or who have weaker breast tissue naturally, an internal mesh bra may prove beneficial in maintaining results long-term. This effective option helps keep implants in place while allowing the patient to enjoy all the benefits offered by their new look.

Correcting Implant Dropping

For mild cases of implant dropping, there are non-surgical solutions available that can help. Breast massages and exercises may be recommended alongside the use of a tensor or compression band, as well as special bras or garments to provide added support. However, remind patients that it is important to always consult with their plastic surgeon before attempting any interventions.

It is important to remember that some dropping is normal and expected with every breast augmentation. Only severe dropping needs to be addressed surgically.

In more severe cases where drooping is pronounced, surgical intervention could be necessary, and techniques vary depending on the severity and cause. These procedures might include capsulorrhaphy (stitching up the breast capsule for a lift) or an internal mesh bra inserted for reinforcement purposes.

Implant Dropping Can Be Addressed and Corrected

In the world of breast augmentation, implant dropping is a normal phenomenon. To ensure that patients feel confident in their decision and have the best outcome possible, they must be well-informed of the causes, prevention methods, and corrective techniques. With an experienced plastic surgeon, individuals can make educated decisions about their journey without any hesitation. PSP

Fadi Nukta, MD, is a long-time board-certified plastic surgeon and the founder and director of Nova Plastic Surgery & Dermatology, located in Ashburn, Va. He is a member of the American Board of Plastic Surgery and the Aesthetic Society.