What to Do If Your Breast Implants Are Sitting Too High After Surgery

One of the most common early worries after a breast augmentation: "My implants are sitting too high. They're not down in the proper position, is something wrong?" It's a really understandable concern, and the good news is that in most cases, this resolves on its own. Let me walk through why it happens and what to do.

Before anything else: check in with your surgeon first. I can't tell you exactly what's going on with your specific situation from a comment, and neither can anyone else online, because a few different things can look like this. You can't get the right treatment without the right diagnosis, so your surgeon should be the one to sort out which of the following is actually happening.

With that said, here are the usual causes.

By far the most common reason an implant sits high early on is that it's under the muscle, and the muscle has spasmed or become really tight.

Here's the mechanism: in the operating room, you're relaxed and under anesthesia, so the implant sits perfectly. But the moment you wake up, you're in a bit more pain, the muscle tightens up, and, up the implant goes. It's the muscle squeezing the implant upward.

The treatment is tincture of time. For the majority of people, simply allowing time to pass will let the muscle relax and bring the implant back down. Some surgeons will also put you in a strap, a tight band that velcros across your chest and gently pushes the implant down over time. That can help, but honestly, time alone resolves this for most patients.

The other common reason is simply that you just had a breast augmentation and your tissue is tight. That tight tissue hasn't had time to stretch and allow the implant to settle into its final position.

This one can happen with both under-the-muscle and over-the-muscle augmentations, if the tissue is tight, the implant can't drop into place yet. And again, the fix is the same: tincture of time. As everything heals and the collagen matures and softens, the implant settles down on its own with no intervention. This is the normal "drop and fluff" process, and it's also why implants end up in different positions before they settle.

Some surgeons will have you massage your implants to help them "on their way down." I'll be honest: I'm not a huge fan, and I'm not sure it really does much. That said, it probably won't hurt. So if your surgeon has recommended massage for this, it's a reasonable option to try, just don't expect it to be a magic fix. Time is doing most of the work.

Here's the scenario that deserves closer attention. You can develop an early capsular contracture from a hematoma (a collection of blood) or a biofilm (bacteria), and a contracture can push an implant up.

The red flag: if your implant is high and, especially, continues to go up as you get out to four to six weeks post-op, you have to be concerned about a capsular contracture. It's genuinely hard for a patient to tell what's going on during this period, because everything can feel tight regardless, but your surgeon should be able to diagnose it. This is exactly why checking in matters.

A lot of patients assume a high implant is from swelling. I don't think swelling is usually the culprit, and here's the logic:

When you're swollen, you're swollen all over fairly evenly, so it doesn't create the targeted, bottom-up force that would lift an implant high. That pattern points much more toward a tight muscle or tight tissue than toward swelling.

If your implants are sitting too high after surgery:

• Check with your surgeon first for a proper diagnosis, several things can look alike.
• The most common causes are a tight/spasming muscle (under the muscle) or tight tissue that hasn't stretched yet (under or over), and both are usually fixed by tincture of time, sometimes helped along by a strap.
• Massage probably won't hurt but likely isn't doing much.
• Watch for an implant that stays high or keeps rising at 4 to 6 weeks, that raises concern for an early capsular contracture (from hematoma or biofilm) and needs your surgeon's evaluation.
• It's probably not swelling, since swelling is global rather than pushing up from the bottom.

For the vast majority of patients, high-riding implants early on are a normal, temporary part of settling, and patience is the real treatment.