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Can Bottoming out Repair Be Done Six Months After Implant Surgery?

asked 9 months ago by anon
Latest answer by Steven Wallach, MD
Question viewed 558 times
Tags: breasts, nipples, bottom out, fuller, repair, shape, shaped, surgery

One nipple points up and it isn't as full on the top as it is on the bottom. How often do patients need more than one surgery to repair this? How common is bottoming out after breast implants?

17 answers to Can Bottoming out Repair Be Done Six Months After Implant Surgery?

Repair of 'bottoming out' implant

Yes, 'bottoming out' can be repaired. It is a challenging procedure, but can be done using permanent sutures. It's not a common problem, but it can happen. In my experience this procedure does not need to be repeated if the patient adheres to my recommendations. I usually request the use of an under wire bra for at least 2 months to insure that the repair heals in place. I also recommend that ample support is always used after that. Best wishes, Dr. H

Gary M. Horndeski, MD
Houston Plastic Surgeon

Timing and Repair of the Bottomed-Out Breast Implant

Hi there- I'm sorry to hear that your breast implant outcome is not as ideal as you would have liked.. By 6 months after surgery, the structure and strength of the capsule your body formed around the implant should be adequate to support a long term repair of the shape of the pocket. There would not (in most cases) be any benefit to waiting longer. Different surgeons will vary in their preferred technique for the repair, but provided your surgeon is experienced in management... more

Armando Soto, MD
Orlando Plastic Surgeon

www.DrArmandoSoto.com

Fixing Bottoming Out

6 months after surgery is usually a good time to wait before attempting a repair for this problem. Usually by this time the capsule is formed well enough to hold stitches for a repair.

Suresh Koneru, MD
San Antonio Plastic Surgeon

Correction of Bottoming out

Bottoming out can happen after breast augmentation surgery. I would suggest correcting it with capsulorrhaphy (internal sutures for better pocket placement) to assist with better placement of the implant on your chest wall. Not every surgeon has experience with this technique – experience is VERY IMPORTANT in this case. I usually ask patients to wait closer to 8-12 months post op to have the internal sutures performed. I have found that the closer the patient is to 1 year... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Unilateral "bottoming out" can be repaired 6 months post-op.

One of your breast implants has dropped and the other remains in a better-appearing position. At 6 months your tissues have healed (nearly completely) and your internal and visible scars have likely faded and softened as well. Wearing a bra or elastic bandeau will not have a beneficial effect on CHANGING implant position, but may help to MAINTAIN position from further dropping. Depending on the technique and practices of your surgeon, you can either have a thin, soft, pliable capsule... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

www.mpsmn.com

Repairing bottomed out implants

At six months, the capsule of the pocket should be sturdy enough to work with inthe repair. Most repairs are done without additional materials like Strattice but in some cases where the tissues are especially thin, it might be best to go to Strattice right away. Other techniques include moving the pocket and creating a new submuscular pocket.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Bottoming out repair

Certainly by 6 months a revision can usually be done to treat bottoming out. Usually this only takes on surgery, but in some cases may require additional surgery.

Steven Wallach, MD
Manhattan Plastic Surgeon

Bottoming out of breast implants

Bottoming out after breast augmentation is usually secondary to the patient's tissue quality, surgical technique, implant size etc. Six months is a reasonable amount of time to allow before correction. An acellular dermal matrix may be required for extra support in some patients. Discuss all options with your surgeon. Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD, DDS
Atlanta Plastic Surgeon

Bottoming out

Secondary surgery occurs about ten % of the time after breast augmentation. 6 months is an adequate time to wait. i would like to see preop and post op pictures before making any further comments . your result may be related to how your breasts initially looked good luck

Jonathan Saunders, MD
Newark Plastic Surgeon

www.drjonathansaunders.com

Implant Repositioning after Bottoming Out

Hi, Malpositioning of a breast implant is one of the more common reasons for breast re-operation. This can occur because of poor tissue quality that lacks support, a heavy implant, excessive muscle activity, and over dissection of the pocket during the initial operation. This can be repaired with another surgery by 6 months, and sometimes sooner in some patients. It is always better to wait longer before repairing this problem to allow full healing. Success of... more

Steven Svehlak, MD
Los Angeles Plastic Surgeon

Bottoming out after breast implant surgery

Bottoming out which describes excessive descent of a breast implant resulting in a seemingly high nipple position, loss of fullness in the upper breast , and a drop of the lower breast fold position, is not uncommon. After six months a revisional procedure can be considered. In most cases only one procedure is necessary to fix the problem, but it is always possible that a revision may be necessary in the case of a over or under correction.

David A. Bottger, MD
Philadelphia Plastic Surgeon

Repair of "bottoming out"

It is common to have one implant shift slightly postoperatively. Typically it so due to the patients bony anatomy,but implant size ,placement and type may all play a role. Six months is a reasonable time for correction but it would also depend on the factors above. Also some patients need to wear a bra postoperatively for several months to prevent bottoming of the implant.

Jay M. Pensler, MD
Chicago Plastic Surgeon

Before and after picture would help

You can have revision surgery if that is what you need. The rate of breast implant surgery revision is around 15-20%.The most common reason for the revoision is the implant size. For transaxillary augmentation the revision rate higher and implant position is the most common problem.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Fix for a bottomed out breast implant

Six months should be a very good time for repair of a bottomed out breast implant, one that is low and projects below the nipple. The problem with bottoming out is not a common one for most practices, and has nothing to do with the type of implant used. The implant has bottomed because of the shape and design of the implant pocket. Suture techniques do offer a secure and effective way to close off the lower pocket, and reset the breast fold to position the implant in the center of the breast... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Bottoming Out Repair Can Be performed 6 Months After Augmentation

You can have your bottoming out deformity repaired six months following your initial augmentation. In fact there are benefits in waiting this long before undertaking the repair (allowing scars to soften and mature and to have less inflammatory process). Sometimes the inferior breast implant capsule can be modified by resection and capsulorraphy in conjucntion with a superior capsulotomy, if the capsular tissues are thick enough to hold the sutures. If not, the... more

John Whitt, MD
Louisville Plastic Surgeon

Bottoming our repair

An implant that settles lower than the other can cause that nipple to appear to be higher on the breast. This can be repaired and the technique depends on how far it settles and the thichness and quality of your tissues. After 6 months the capsule (scar around the implant) should have matured to a point to allow this repair. The only way to know for sure is an in-person physical exam. I recommend you return to your plastic surgeon to discuss your options. I hope this helps. Dr. Edwards more

Michael C. Edwards, MD
Las Vegas Plastic Surgeon

www.medwardsmd.com

Bottoming out after Breast implant surgery

Bottoming out occurs when the implant stretches the inferior aspect of the pocket and drops inferiorly. This can make the nipple appear high and the lower pole of the breast too long. The repair can be performed 6 months after surgery. It seems to be more common with saline implants than gel implants, but can occur with either type, and may be more common with larger, heavier implants and in cases where the old inframammary crease needed to be disrupted and lowered (if the... more