I am often asked, “When can I stop wearing a bra after breast augmentation?” or “How long do I need to wear a bra after breast augmentation?” The answer to this question is very simple: it is essential that all breast implant patients wear a bra day and night for the rest of their lives! Evidently, there is much confusion and misunderstanding because patients are shocked when I tell them of the need for constant bra use. Patients have told me that “My surgeon never really told me that I needed to wear a bra after breast augmentation” or, worse yet, “It’s not necessary to wear a bra after breast augmentation because you have breast implants.” I can’t figure out why it is that women who have had breast enhancements were not told that they needed to wear a bra, even in bed! There is nothing about a breast augmentation that makes a bra optional.
A breast implant is a significant weight added to your breast. A 350cc saline or silicone implant is about 1.5 pounds. This weight, over time, will stretch the tissues of your breast and chest area if unsupported. This is made worse in those patients who have larger implants, have poor skin quality, or engage in activities that cause bouncing breasts, like runners, tennis, and volleyball players. This added weight falls victim to gravity (that force that acts on all objects to pull them down to the ground). The result of this stretching is bottoming out, double bubble deformity, excessive lateral displacement, “floppy” breasts, rock-in-the-sock deformity, and displaced nipple-areola complexes with breast asymmetries.
“Any breast that is soft and has an implant that moves will benefit from a supportive bra.”
The only exceptions are when a patient has firm, non-mobile implants. This could be because of a breast contracture A contracture occurs when the scar tissue layer that forms around all breast implants becomes excessively thick and firm. This squeezes the soft implant and makes them feel hard and immobile. They are “stuck” to your chest so stretching of the skin is uncommon. Breasts may also be immobile because textured implants were used, which are designed not to move. Any breast that is soft and has an implant that moves will benefit from a supportive bra.
The photo sequence above clearly shows the “settling” of breast implants that occurs in the early period after breast augmentation, which takes about two months. Breast implants sit up quite high immediately after placement and then gradually settle with time as they expand the skin and muscle and drop lower. There is a lot of superior breast fullness, they feel like they are sitting under your chin and the shape is clearly not ideal (unless you absolutely love the exaggerated superior fullness!)
The right hand photos in this sequence show near-perfect settling of her breast implants. The breast implants are no longer sitting up so high and her breasts have now assumed a more ideal shape and proportion. Once your implants have settled nicely, it’s time to “lock and load”. This means wearing a bra with proper working support to keep your breasts “up and in.” Your bra should support your breast implants instead of your skin. If you wear the correct bra, you should enjoy an ideal breast shape for a much longer period of time. Why would you not want the most beautiful breasts possible now and well into the future?
What happens if you don’t use a bra? The effect of gravity will take hold of your breasts and the breast and implant will move down and to the sides over time. They move down when you are in the standing position, and they move off to the side when you are lying on your back. There is no way to avoid this eventuality unless you were a bra.
“Breast revision surgery is quite common because of the negative impact of overly large sized breast implants and not wearing an appropriate bra to support them.”
Now, in all fairness, the process is not going to harm you, but it will make your breasts less attractive and youthful looking. I don’t know many women who prefer low hanging breasts or those that move under their arms when lying down. One of the most common requests that I see in my Austin plastic surgery center’s Breast Revision practice is to reposition breast implants where they should be. Patients complain of low breasts, breasts that move under their arms when lying down and breasts that are too lateral. Breast revision surgery is quite common because of the negative impact of overly large sized breast implants and not wearing an appropriate bra to support them.
The choice is yours. You can wear a supportive bra that holds your breasts “up and in” or be prepared for the slow process of breasts moving “down and out”. Look at the good side; your breasts will always look their best. Bras can be supportive and sexy, and you can even wear a push up bra. Once you get used to wearing a bra with your new breasts, you can’t imagine not wearing one!
— Robert Caridi, MD
Diplomate of the American Board of Plastic Surgery
Fellow of the American College of Surgeons (FACS)
Member of the American Society of Plastic Surgeons (ASPS)
Member of the American Society for Aesthetic Plastic Surgery
Founder of the Austin Gynecomastia Center
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