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Have I Bottomed Out? I am almost 12 wks post-op and I've noticed my right breast isn't sitting the same as the left. (photo)

I am almost 12 weeks post-op and I've noticed that my right breast isn't sitting the same as the left one. I have been reassured that my result is consistent with normal, but I can't shake the feeling that something is wrong. It feels uncomfortable and heavier on that side, like it's not supported. Sometimes I get a 'pulling' feeling, which is uncomfortable and at times painful. I really wanted a natural look, but especially from the side and when I raise my arms they look anything but. :(

Doctor Answers (11)

Bottoming Out after Breast Augmentation?

+2

Thank you for the question and pictures.

 Your concern is understandable given the appearance of your breast with your arms elevated. You certainly have breast implant position asymmetry/displacement.

 Given that you seem to have symptoms related to the breast implant positioning, I think that you may end up benefiting from revisionary breast surgery at some point. This surgery may involve reconstruction of the capsule tissue along the lower pole of the involved breast,  supporting the breast implant in a higher position.

 This procedure is called capsulorrhaphy  and involves the use of internal sutures to reconstruct the breast implant “pocket”.  You may find the attached link helpful to you as you do your research.

 I would suggest that you communicate your concerns with your plastic surgeon as you have done here. Make sure that he/she can demonstrate significant experience helping patients in your situation. 

 Best wishes


San Diego Plastic Surgeon
5.0 out of 5 stars 722 reviews

Bottoming out

+1

You definitley have bottoming out on the one breast and could benefit from a capuslorrhaphy on that side.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Implant too low

+1

Yes I believe that the implant, on what appears to be your left breast, is coming down below the inframammary crease. There's a slight chance you can  fix this by wearing a good elastic or wire underwire bra. Most likely you will need a revision but I would wait 3-6 months. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 24 reviews

Have My Implants Bottomed Out? (photo) #breastimplants

+1

Well.....You have at least when your arms are up! In the straight on view you look pretty good and considering you did have some droop before your surgery. But it does look too low on that side. You can try conservative treatment, like wearing a wire bra full time and see if that fold will stick back down...but I doubt it will...You most likely will need a procedure to lift that up and that should make it feel better as well..

John J. Corey, MD
Phoenix Plastic Surgeon
4.5 out of 5 stars 17 reviews

Double Bubble

+1

It appears from your pictures that you have a condition called a double bubble. That happens when the inferior mammary fold is released and the implant "slides" below the fold and creates an appearance of a second inferior breast pole, hence the double bubble appearance. This requires revision surgery with either a capsulorrhaphy (capsule correction with sutures or other methods), use of allograf material such as stratisse or creation of a complete new pocket for the implant "neopocket". The revision surgery should be done the earliest at 3 months after the original surgery but preferable at 6 months. Bottoming out refers more to a condition were the tissues of the breast in the lower pole are thinned out and give so the implant appears as it is streching the lower breast tissue but the IMF is still present and visible.

Tal T. Roudner, MD, FACS
Coral Gables Plastic Surgeon
5.0 out of 5 stars 80 reviews

Have I Bottomed Out?

+1

Very hard to determine the "bottoming out" effect in your case. Because you posted only arms above hard in side views. I believe you are borderline "bottomed" but ONLY in person examination can address this issue. Seek second opinions in person. Otherwise appears as an acceptable result. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Bottoming out

+1

The one implant has bottomed out.  It is probably too early to have a secondary surgery, as others have suggested.  For a patient who is experiencing symptoms, it may be appropriate to do surgery earlier.

 

Talk to your surgeon again.  None of us wants an unhappy patient or a less than optimal result.  Most of us will try to address your concerns, if we can.

Michael S. Hopkins, MD
Albuquerque Plastic Surgeon
5.0 out of 5 stars 42 reviews

Bottoming out after breast implants can be corrected.

+1

Hi.

You do have bottoming out on one side.  The best thing to do is wait another three months, and then get another opinion.  You can consider revision then.  This can be fixed.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Bottom out question

+1

Hi Miss8972,

thanks for the post and the question. your concerns are valid. However there is nothing WRONG, despite the fact that this isn't perfect either. You have some implant position issues on the right. It does seems to sit lower. However, from the arm down position, it looks fine. 

I agree with the other opinions here that although you seem to be healing well and i am sure you don't see this in clothing, you may need some tightening and capsule revision in the future. 

you should discuss this with your PS. sometimes, a strong underwire will help seal the scar tissue to prevent any further drop. Make sure you are eating healthy and getting enough protein. I generally recommend a daily multivitamin. The wound healing process requires a complex number of nutrients to work properly and we so often don't have a fully balanced diet. 

Best wishes.

 

Bennett Yang, MD
Rockville Plastic Surgeon
5.0 out of 5 stars 8 reviews

3 Months after Breast Augmentation and Bottoming out

+1

    While it does appear as though the fold is lower on one side, the result with your arms at your side is good, given your preoperative anatomy.  I am a bit handicapped here, because I do not know exactly where your folds were preoperatively.  A pocket revision can certainly be performed to close down the inferior pole, but I would have to examine you while holding the new fold position.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 203 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.