How long to see results with direct implants

Was your implant under the muscle? If so, it can take 3-4 weeks on average for it to drop and fluff.

Your PS should be able to instruct you on how to massage the implant/muscle area to make the process easier and potentially take less time but, on average, it takes 3-4 weeks for it to happen even with massage.
Keep in mind that it can also take up to 6 months before you'll see what are the final results as there can be residual swelling in the area for about that time period, so if it still doesn't look good to you after that time frame, it'd be time to talk to your PS about having a revision done.

A lot of what I've read on reconstruction & implants (I did a lot of reading up on it prior to my BMX to decide whether I wanted it or not) seems to have a theme between a lot of women who have implants, either for just plain cosmetic reasons or for reconstruction after a mastectomy: A lot of worry about where the implant is sitting and a lot of dissatisfaction for the first few weeks, especially in the under the muscle procedure vs the over the muscle (which seems to settle & fluff faster, from what I read).
Most of it seems to stem from the fact that, for the first few weeks, the implant seems to sit higher on the chest and doesn't really feel or look much like a "natural breast", but the majority of it stems just from the swelling in the chest muscle and surrounding area, and once that starts to resolve, you then see the implant settle into a more natural position and take on a more natural look.

However, I also found that, for most women, after that 3-4 week mark, when the chest muscles begin to relax and the implant drops and fluffs properly, and definitely after the 6 month mark, their view of it changes as everything settles into place and all of the swelling resolves, so it really may just be a matter of being patient (as difficult as that can be; even with no recon, I still wanted everything to look perfect and nice within a week and it was hard when it didn't, even though I KNEW it wouldn't!).

That's not to say something can't still go wrong, or that you definitely won't need a revision, just that you're likely to be told by your PS to give it some time to settle and have the swelling go down before they start looking at it in terms of something that might need a revision or a different reconstruction method if you're not happy with how the reconstructed with implant breast looks in comparison to your other breast.
If your PS hasn't shown you how to massage it, definitely ask, as the reading up I did on implant aftercare did mention that doing massages after the first week and routinely after that can help prevent scar tissue/capsular contractures from forming around the implant.
There are some really good videos that show how to massage breasts after an implant procedure if you search "breast implant massage" on Youtube, but I'd also definitely recommend asking your PS about it as well.

It's probably going to look less than stellar for at least 3-4 weeks no matter what, though, which kind of sucks, but it's that way for nearly everyone.
If it's still looking not quite right to you or you're not happy with the symmetry after that time, then certainly bring it up with your PS again and see what they say.

Edit to note: If you have shaped or textured implants, however, massage isn't necessary as you don't want to accidentally flip a shaped implant and, for textured implants, they're intended to have the scar tissue grow around the texture.

Thank you for asking this question. I just had my exchange surgery on Oct 12 and (although I'm still wrapped up and wearing a binder), I'm not thrilled with how the recon looks. It's very high on my chest (maybe even higher than the TE was, if that's possible!) and flat. It doesn't have the shape of a real breast at all. And it looks very small. I saw my PS after I came out of recovery and when I told her it looks small she said she put a 685 in, which apparently is big. I haven't been told anything about "dropping and fluffing", so that was helpful to know. I see the PS on Monday for follow up so I will ask.

Konjkav28, I hope with some time you fall in love with your new breast!

(((Hugs)))

It's a High Profile, Medium Height. silicone implant.