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Are my Breast Implants Bottomed Out?

asked 1 year ago by BRGirl in Brazil
Latest answer by Enrique Etxeberria, MD
Question viewed 2,972 times
Tags: age 25-34, 130-149 lbs, 5 ft 4 in to 5 ft 7 in, 300-349cc, bottom out, cohesive gel, high profile

Hi, I´m from Brazil, 34 years old female and 7 weeks post op. Since 1 week pots op I concerns about my left breast has bottoming out. I am a thin patient (130lbs, 5ft4in. 34A pre-op and did 330cc perthese ultra high gel coesive implant. My breasts before were very symmetrical though! Dr. said that we will wait at least 3-6 mths before we decide on anything. He would never say to me bottoming out though. What can I do now? Are my breast implants bottomed out?

26 answers to Are my Breast Implants Bottomed Out?

Breast asimmetry

Analyzing your photographs, there is -currently- an asimmetry: the right breast inframmamary fold is a little bit lowered comparing with the left side. i don't think it's a real bottom out. I think that in a very near future (3-6 month postop it will have to be fixed surgically [reconstruct the lowered fold]. It's very soon in this moment. I would try to use a "chest-band" (Veronique) -2 inch width- during daytime trying to fix the problem. In the other hand,... more

Enrique Etxeberria, MD
Spain Plastic Surgeon

Bottoming out

It looks like in the photo that the right implant is bottoming out a bit. An in person exam would be helpful. To treat this usually requires resuspending the fold internally with sutures and often placing smaller implants.

Steven Wallach, MD
Manhattan Plastic Surgeon

Probably not bottoming out

Dear BRGirl I don,t think this is bottoming out but it probably is a lowering of the infra mammary fold. I would wait at least three months before doing a repair and might consider using alloderm or Stratford to reconstruct a lowered fold. Without seeing you pre op photo it may be that your folds were asymmetric before surgery and this is exaggerated by the surgery. Good luck but wait three months before the repair. Dr. Schuster in Boca Raton.

Steven Schuster, MD
Boca Raton Plastic Surgeon

www.schusterplasticsurgery.com

Your Right Sided "Bottoming Out" Is Easily Repairable

Your Right sided implant is positioned too low and will have to be moved up at about 6 months after surgery. Al though "Bottoming Out" is used to describe implants that have expanded the lower portion of the breast excessively usually much later than 7 weeks, your right breast implant is positioned too low. This has caused a noticeable difference in your breasts (asymmetry) and will probably have to be fixed surgically. You should wait... more

David L. Mobley, MD
Sarasota Plastic Surgeon

Breast asymmetry after breast augmentation

Certainly your photo shows significant asymmetry in the breast. The fold on the right is indeed lower and this may be related to shape and asymmetry beforehand. It could be caused by an implant pocket which is simply too low on the right. The fold may have to be reset but Best now to wait though and let the skin envelop relax and accommodate the implant. Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon

Bottoming out

From the photos it looks like possibly there is some implant mal-position of the right breast. You are only 7 weeks post op and you need to allow for things to heal completely before considering revisionary breast surgery. I perform lots of revision breast surgery and almost always ask patients to wait 6 months to 1 year to allow for complete healing and also this time frame will allow for a better result with the revisionary surgery. To correct "bottoming out",... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

I had bilateral breast augmentation in Brazil Are my breasts bottoming out?

It looks like your right infra mammary fold was released. The right implant is assuming a lower position that is why you right breast it less full on top. You are going to require a capsulorrhaphy on the right lower breast fold to make you symmetric.

Farhad Rafizadeh, MD
Morristown Plastic Surgeon

Breast Augmentation asymmetry

BRGirl, You do have asymmetrical results, but it would be helpful to see your pre-surgery pictures to be able to fully comment. It does appear that your right breast shape is different and lower than the left breast. Do you have shaped implants? It is possible that the implant has rotated. If you have round implants then perhaps the implant has displaced itself. If you are unhappy with your surgeon's recommendation, you should not feel guilty about... more

Martin Jugenburg, MD
Toronto Plastic Surgeon

Breast contouring, #BreastAugmentation, #Breastlift, #mastopexy, #breastimplants

Dear BRGirl in Brazil, Thank you for your question. Which Breast do you like better? The difference in the shape of your breasts can be helped with a bandeau to push the left breast down ( if this is what you would like to see). Over the next couple of weeks you should see a change. If your shape was symmetrical to begin with - then a symmetrical result can be achieved. With Warm Regards, Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon

Bottomed out?

Brazil, If anything, it appears that your right implant is low. This is most likely a consequence of placing the implant too low and not a "bottoming out" per se. Bottoming out usually takes place over months or years. I would also venture to say that your breasts were probably NOT symmetric before your surgery. A look at the pre surgery photos will confirm that. At any rate, it is common practice to wait 3-6 months before critically evaluating the... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Bottoming Out Vs Malposition???

I would agree, the terminology is kind of vague. If you came to me 1-2 years after getting your implants complaining of the assymetry now that was perfect before, I would diagnose your right implant as having bottomed out, but only "slightly". If you have this appearance at 1 week post op, then the right implant has been positioned slightly too low. This may have been in an attempt to release an inframammary fold that was too high, or from release of a Pectoralis muscle attachment... more

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

Implants bottomed out

The term bottoming out is very non specific. It is better to think of implant displacement that creates an undesired or unaesthetic appearance to the augmented breast. It is difficult to give advice from photographs which is complicated by the fact that the implants you discuss are not available on the US market. From your photographs, it looks like the distance from the nipple to the fold on the right side is increased versus the left. At this point, I am... more

Richard J. Wassermann, MD, MPH
Columbia Plastic Surgeon

Bottoming out?

Looking at your current photos at 7 weeks post-op it would appear that the right breast inframammary fold (the line where your breast meets the chest wall) is lower than the left. This could be due to several factors. The first is that your breasts were not truly symmetrical before surgery. You stated that your breasts were symmetrical before surgery but what you using as your guide? Was it the nipple position, the shape of your breasts or the inframammary fold?... more

Donald M. Brown, MD
San Francisco Plastic Surgeon

Are my Breast Implants Bottomed Out?

Thanks for the photo series of the appearance now. I would like to see before photos, because I might disagree with your statement, "My breasts before were very symmetrical". The right N/A complex appears higher and more lateral, with a lower inframammary fold pocket. While the left breast has medial inferior displacement or pocket formation with a lower N/A complex. I recommend obtaining second opinions and having a revision at 3 months. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Your left breast is fine and right breast inframmary fold is disrupted and bottoming out

You have bottoming out of the right implant due to the disruption of the infra mammary fold. This can be due to the anatomical variation before surgery or due to the surgical detachment. Your before surgery pictures will help. You will should have revision and you can have this now rather than later.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Bottoming Out Implants

From your photos it appears that if have bottoming out at all, it is on your right side rather than the left. Your implants are not excessively large, but may be a bit large for your pre-op situation. Implants which are too large are a leading cause of "bottoming out". I agree that 7 weeks is too soon to see what your final result will be and suggest that you wait awhile before considering any secondary surgery.

John Whitt, MD
Louisville Plastic Surgeon

Breast changes

While looking at your photos it is very apparent that your nipples are in different positions. If you draw a horizontal line one will be above and the other below. This is normal in most women. The optical allusion is giving the asymmetry. The distance from inframmary fold to the bottom of the nipple complex is different side to side. A question to ask your self is in clothes can you see the difference. And is it worth scars to move the nipple... more

Rodger Wade Pielet, MD
Chicago Plastic Surgeon

Post op breast implant asymmetry

Thank you for the photos. If you were truly symmetrical pre-op (which is not the average patient), your post op photos at 1 week suggest a lower pocket on the right side rather than the left. There is the possibility of rotation, or malposition, of the cohesive gel implants adding to the perceived asymmetry. I agree with my other colleagues that it is too early to judge symmetry when the inflammatory swelling has yet to resolve. Please be patient with your surgeon and... more

Randy Wong, MD
Honolulu Plastic Surgeon

Breast asymmetry following breast augmentation

Youre postoperative views demonstrate asymmetry especially over the lower breast pole (distance from the nipple to the inframammary crease. This distance is much longer over the right breast. The only way to know if this is bottoming out is to look at your preoperative photos to see if this distance was indeed longer before surgery. If it was longer preoperatively, then it should have been corrected by taking out a wedge of your skin and soft tissue during surgery. If it is longer only on... more

Arian Mowlavi, MD
Laguna Beach Plastic Surgeon

7 weeks after augmentation not necessarily final result

Your surgeon is probably right that the final result may not be seen at 7 weeks. With your arms down the photos do not appear to show bottoming out but there is some asymmetry with the fold on the left appearing higher. If they are the anatomic implants you will probably not see much settling though.

Richard Baxter, MD
Seattle Plastic Surgeon

Breast Asymmetry after Surgery

Without seeing pre-operative photos and examining you in person, it is impossible to know for sure what is going on and what, if anything, can be changed. Your left breast appears okay while there appears to be asymmetry between your left and right breasts in the neutral position. Your surgeon is correct in suggesting waiting 3 to 6 months before entertaining any type of revision. Good Luck.

David Shafer, MD
New York Plastic Surgeon

Breast augmentation results are not immediate

In my opinion, it is really too soon to predict the ultimate result. It will be important to stay in touch with your surgeon and follow-up as you are directed.

Christopher J. Davidson, MD
Wellesley Plastic Surgeon

Bottoming out implants

Bottoming out is a misused, descriptive term. It implies that something, either the implants or breast tissue, has sagged or displaced lower than what is desired or expected causing an aesthetically unacceptable result. You would need to know what your original breasts looked like and what was specifically done at surgery. Most, if not all, patients have some asymmetry with their breasts whether it is position of the nipple relative to the breast mound or relative to the chest wall,... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Implants bottoming out at 7 weeks

Although it is too early to conclude or do anything about it at 7 weeks, it appears that the left breast is perfect and where one would expect it at 7 weeks but the right side is "bottomed out' in the sense that the inframammary crease area is stretching and lowering. In my experience this is most common in implants that are too wide or too projected for the breast and the implant doesn't stay where it was set until it is solidly healed. It can also be caused by inadequate... more

Scott L. Replogle, MD
Denver Plastic Surgeon

Implants are asymmetrical

It is still too early to make decisions about what to do. Your breasts are asymmetrical now, with the right implant sitting a little lower than the left implant. In my opinion, your implants are a little too large for your body - they would fit better if they were smaller. Your nipple position is also asymmetrical, but it probably was prior to surgery. The larger the implant, the more obvious the nipple asymmetry becomes. All things considered, you still have an... more