Does Wearing a Bra Protect Breast Implants from Bottoming Out?

Hi there-
While I do believe that a good support bra is important after augmentation surgery (especially when implants are placed under the chest muscles), I don't think that the bottomed-out appearance, where there appears to be excessive skin showing between the fold under the breast and the nipple, can be prevented by using one. The primary cause of a bottomed out appearance would be violation or lowering of the inframammary fold structures (either deliberately or inadvertently) at the time of surgery.
In a minority of patients, an initially lovely result can over time appear more bottom heavy, indicating a possible need for a breast lift, but a truly bottomed out appearance soon after surgery would most likely be due to technique and not the bra.

There doesn’t appear to be a consensus amongst plastic
surgeons regarding the use of bras following breast augmentation surgery. Many
plastic surgeons tell their patients it doesn’t make a difference while others
tell their patients that bras are an absolute necessity in the post-operative
period. Unfortunately, there are no scientific studies that clarify this issue.A complex relationship exists between breast tissue,
wound healing biology, breast implants, and gravity in patients who have
undergone breast augmentation surgery. It makes sense that breast implants can
exert significant downward pressure on the soft tissue of the breasts. Over the
course of time, this might lead to soft tissue stretching and bottoming out of
breast implants. For this reason, we feel it’s appropriate to wear a bra
for support following breast augmentation surgery. This is especially true when
larger implants have been used and placed on top of the pectoralis muscles. It’s important to realize that each patient’s situation
is unique. For this reason, postoperative care should be individualized. Under
these circumstances, it’s appropriate that you discuss this issue with your
plastic surgeon. Your surgeon should be able to formulate a treatment plan
that’s appropriate for you.

My experience after nearly 3 decades of observation is that in many cases bra wear most days in general do help prevention of bottoming out over the life time of the implant. This applies to all implants and especially with smooth implants that are place over the muscle (subglandular). They of course would not be of benefit at night as gravity and implant weight is not at work pulling the implant downward.