After breast reconstruction, your body needs to heal before you can get a good idea of the final result. But some people are still surprised when they first see their new implants.

“I just had my second surgery today, the switch between my tissue expander and permanent implant,” said one MyBCTeam member. “It looks flat! I just peeked under my bandages and was disappointed to see it’s like a pancake over where my breast was.”

If you’re concerned about flat implants, there are a few facts you should know. It’s possible things will improve after full breast augmentation recovery or that future procedures can help you achieve the look you want. “Give it time to settle — at least two months,” advised a MyBCTeam member. “You can always have revision surgery. I had a revision surgery six months after my swap out.”

Read on for reasons why your implants may appear flat at first and how to know when it’s time to talk to your doctor about your results.

1. Your Implants Haven’t ‘Dropped’ Yet

In the first few weeks after a breast augmentation, it’s normal for implants to seem high, flat, and sometimes even a little bit square. That’s because the skin and muscles around them are tight and haven’t had time to stretch and accommodate the implant. Once your body adjusts to your new breasts, the implants should seem rounder and more full. If less than six months has passed since your procedure, try not to judge your body too harshly.

2. The Implants Are the Wrong Size or Shape

A board-certified plastic surgeon should advise you on the best type of implant as you plan your procedure. Implants vary in width and projection (how far out they stand out from your body), so it’s important to choose the best fit based on your body frame. Selecting the right implant size and shape is crucial if you want natural-look plastic surgery after a mastectomy. Sometimes doctors underestimate the size of the implant that is needed. However, if the implant is too big for the available space, it might lead to visible rippling and a flatter appearance.

Sometimes teardrop-shaped implants can help create a more natural breast shape. One member of MyBCTeam explained their decision-making process. “At first, I was set to get the teardrop but have since changed my mind. After talking to my plastic surgeon, we decided on the round ones to give me more projection. I was a DDD before and only want to be a C/D because I have a narrow rib cage. The teardrop ones won’t give me the breast size I want.”

3. The Position of Your Implants Needs Adjustment

Implant displacement can happen during surgery or after. During reconstruction, the plastic surgeon must make incisions to create a pocket within the breast tissue to hold the implant. If the pocket isn’t exactly the right size, implants may move too far apart and not maintain the intended look.

Let your health care provider know if you suspect the implant has shifted and you’re dealing with asymmetry, flatness, or other aesthetic concerns.

4. An Implant Is Leaking or Ruptured

Implants may change shape or become flat if their fluid leaks out. It’s unlikely for newer implants to leak, due to improvements in construction and design. But it’s still possible after an accident or significant injury to the chest. During breast augmentation, surgical tools may rupture the implant. In addition, compression applied during follow-up mammograms can also damage an implant. If your implant is punctured, you may notice swelling in the lymph nodes of your armpit.

Saline implants deflate almost immediately when punctured, and for this reason, it’s usually not necessary to have an X-ray or scan to diagnose the issue. However, a ruptured silicone breast implant may take longer to show. Your doctor can perform an ultrasound or an MRI scan to find out if silicone gel is leaking.

Fortunately, ruptures are not a life-threatening emergency. Nonetheless, your doctor will need to remove the deflated implant and replace it to fix the problem.

5. There Are Post-Surgery Complications

Post-surgery complications can also contribute to the flat appearance of breast implants. Issues like infection, bruising, or seroma can disrupt the healing process, affecting the positioning and projection of the implants. Early detection and proper management of these complications is crucial for optimal results and for your safety.

Capsular contracture is the most common complication following implant surgery. It occurs when scar tissue forms around the breast implant, causing it to harden and change shape. This can lead to a flattening effect as the implant becomes constricted. Surgery might be needed to address severe cases of capsular contracture.

Next Steps

If your results still fall flat after healing from surgery, it might be time to talk about your options with your doctor. “After my exchange surgery, my plastic surgeon did fat transfer surgery to help contour and sculpt my breasts to look more like breasts. I also needed nipple reconstruction,” explained a MyBCTeam member.

Having breast revision surgery might be the last thing you feel like doing. Unfortunately, it’s not unusual for people to need revision surgery, a breast lift, or further enhancement after an initial breast reconstruction. If you’re unhappy with your implants after your body has had enough time to recover, you can consider removing them altogether. Implant removal is a difficult decision, but one that some members of MyBCTeam report being happiest with. Adding a mental health professional to your support network can help you process the emotional aspects of cosmetic surgery for breast cancer.

Unless there are complications threatening your health, it’s OK to wait until you’re ready before undergoing a corrective procedure after breast augmentation surgery. In fact, waiting might give you the best opportunity for a safe recovery and satisfactory results. In the meantime, a well-fitted, padded bra could help provide your desired look in clothing.

Talk With Others Who Understand

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 64,000 members come together to ask questions, give advice, and share their tips with others who understand life with breast cancer.

Did your breasts initially look flat after augmentation? Did you need revisions to get the results you wanted? What advice do you have for someone considering implants? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.