High-riding implants after transaxillary augmentation: settling or problem?

The settling curve

Weeks 0–6: high, tight, flattened upper poles — the 'implants on the collarbone' phase every sub-muscular augmentation goes through. Months 2–3: the muscle relaxes, the lower pole begins to fill. Months 3–6: the implants settle into the lower pole, softness returns, the fold looks natural. Through the armpit the curve can run slightly longer because the muscle's lower fibres are released from above under the endoscope, and the band in the first weeks deliberately holds the implants down.

Normal versus problem

Normal: both implants high early, settling month by month, one side ahead of the other. Problem: an implant that hasn't moved by month 6, with a tight upper pole and an empty lower pole — the sign of incomplete muscle release at the fold, the classic blunt-technique complication. Endoscopic release prevents it; when it occurs, correction is through the fold incision, releasing the muscle under direct vision.

What helps settling

Patience first; the band and arm rules in the early weeks (to prevent the opposite problem — lateral drift); gentle downward massage from week 3 when advised; no underwired bras pushing the implants up until month 3. The risks page covers malposition in full.