Women who are planning to get breast implants must know how the implants change over time. You may have heard about breast implant sagging, settling or fluffing, but, many patients often misunderstand these descriptions of the changes that breast implants undergo. Patients who have recently gotten breast implants may not immediately see the aesthetic improvements they expected from the procedure. This doesn’t mean they would never see the imagined results. After the breast augmentation surgery, the breasts start to evolve, and it takes time for the implants to settle and deliver to you the promised results. It is important to understand that it may take up to six months before you can see the final results of your breast implants. While the implants settle in majority cases, they may fail to settle in a few patients. This can be extremely distressing for the patients. How do the implants settle? To better understand why some breast implants do not settle, it is important to know first how the implants settle. After the breast augmentation surgery, the implants are normally positioned higher on the chest. This will continue throughout the healing process, which may take a few weeks. When the implant is positioned underneath the breast muscle, it normally stirs the muscle, causing it to exert a force on the breast tissue. After a few weeks, the settling process will start, and your breasts will begin dropping and fluffing. Your breast muscle will relax and the implant will drop into the intended place. Why implants fail to settle Majority of implants do settle smoothly, but some implants may fail to settle. Proper settling of implants depends on a variety of factors, the most important ones being the type of implant, placement and size and the dimensions of your chest wall and breast tissue. Implants can either be placed underneath or over the breast muscle. Most breast implants are placed underneath the breast muscle. While this type of placement has a good track record of implant settling, there is still a minor risk the implant may fail to settle. Normally, it takes a maximum of three months for the implant to settle. If your implants fail to settle within 3-6 months after the breast implant surgery, you should immediately contact your plastic surgeon. In comparison, implants placed over the breast muscle boasts a very good record of settling. These implants settle fast as compared to implants placed underneath the breast muscle. The breast implant placement that is best for you will be determined by your plastic surgeon, who will recommend you the best option after careful consideration of your body type, personal goals, and implant type. The shape, size, type, texture and material of the implant will have a greater impact on the implant behavior during the healing process. There are two basic types of breast implants: silicone and saline. Both types of breast implants are either in round or teardrop shape. The round implants are smooth while the teardrop implants are textured. The round implants have a better record of settling while the teardrop implant comes with uncertainty in terms of settling. There have been a few cases wherein the teardrop implants have failed to settle properly. Furthermore, if the implant size is not proportionate to your chest wall dimensions, there is a chance of implant settlement failure. This is the reason why it is important to choose the right size of breast implants so that it perfectly fits your chest dimensions. Your plastic surgeon can help you choose the right implant size. Implants that are too large or too small may not settle properly, necessitating a revision surgery to correct the condition. It is important to understand that normally after the breast augmentation surgery, round implants are temporarily flattened due to tightening of the breast muscle. This often makes the implants appear higher on the chest wall. Over time, the breast muscle will relax and accommodate the implants. After six weeks, the implant will settle into a natural position. However, there is a risk that the implants may not settle properly, or one of the implants may fail to settle at all. This is particularly true for people like athletes, who have unusually strong pectoral muscles. Settling may take longer for these types. How to ensure the breast implants settle properly There are some methods that can be employed to help the breast implants settle. Some plastic surgeons prescribe medications that help relax the breast muscle so that the implants can be comfortably accommodated into place. The second most commonly used method for implant settlement after breast augmentation is breast massage. People specifically trained for massages after plastic surgery normally perform the medically prescribed massage, which helps the pectoral muscle to relax and make room for the implant to settle. Conclusion Whatever choices you make for the breast augmentation surgery, please note that the ultimate aesthetic outcomes of the procedure will not be immediately visible. The breast implants need time to settle into its intended place and position. Do not get anxious or nervous while waiting for the implants to fall into place. Recovery takes time. Almost all implants finally settle, but it is also true that there are isolated cases when the implants may fail to drop and settle properly resulting in lopsided or misshapen breasts. Implants fail to settle for several reasons. The most common reasons would be very large or very small implants, implants that are not proportionate to the chest dimensions, bad implant material, poor implant placement, surgical error, inexperienced plastic surgeon, strongly developed breast muscles and breast implant type and shape. In order to hasten the breast implant settling process, some plastic surgeons recommend medications or breast massage by specially trained therapists. That said, the best way to preclude breast implant settlement failure would be to choose a highly qualified and highly skilled, Board-Certified plastic surgeon to perform your breast augmentation surgery.