Breast Implant Revision: Q&A

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Are my Breast Implants Bottomed Out?

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?

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age 25-34 5 ft 4 in to 5 ft 7 in 300-349cc 130-149 lbs bottom out cohesive gel high profile Perthese

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33 Doctor Answers | Asked by BRGirl in Brazil

Doctor Answers (33)
Community Comments (0)

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

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

12 reviews

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.

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

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

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

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.

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

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

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

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

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

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

8 reviews

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

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

28 reviews

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.

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

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

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

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.

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.

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.

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

4 reviews

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

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

Wait and See

You are still too early out to determine anything at thois point-stay in contact with you doctor and monitor your progress

Bottoming Out

You do have some bottoming out on the left side, and I would recommend the Internal Bra to correct the situation and support your implants in the future. I do not feel it is necessary to downsize at the same time unless you want to. In fact most of my bottoming out /Internal Bra patients go up in size.

Bottomed out implant

Hello, You seem to have rather nice looking breast with nominal infra-mammary fold difference and as suggested by Enrique Etxeberria, MD using a chest band that I sometime use to treat tummy tuck scars over the Silicone Sheet may keep the right implant pushed up during healing phase.I think you should be vary happy with the overall result and with yourself.

Implant Malposition vs Bottoming Out

The Plastic Surgical term "bottoming out" usually refers to a problem that occurs after breast reduction surgery where the nipple to inframammary crease distance increases causing the nipple to look upward. What you have is an implant malposition with the right positioned lower than the left. It is usually best to wait 3-6 months for the normal left implant to settle completely then revise the right implant pocket to match the right.

Paul S. Howard, MD

3 reviews

Birmingham Plastic Surgeon

Breast augmentation result best assessed several months postop

Thank you for your question. You understand that it is usually best to wait several months at a minimum before making any assessment about the result. The reason that this is important is because the result will continue to change for several months, and what you see now may not be what you see in 3 months or something else could change. That being said, from your current photographs, the left breast looks OK to me. And this is the one that you are worried about,... more

Tincture of Time often needed for Breast Aumentation final results

It does not appear if you are bottomed out. Many changes occur following breast augmenation in the first several months. Without comparing you preoperative photographs it is impossible to make a diagnois. At this point I agree with your plastic surgeon to weight 3-6 more months before any decisions are made.

Breast Implant Bottoming out post op

You look amazing! I agree with you that the right implant is lower than the left. As it is early after your op this is likely to be caused but too much release of the fold rather than bottoming out. This may need adjusting after 3 months, but in the meantime I recommend that you wear a firm bra with an under-wire day and night to support the fold on the right. This may help to improve the fold and stop this from getting worst. Hope that this is helpful. more

Achieving more symmetry of the breasts after augmentation

There are some assymetric features of the two breasts. Treatment should be based on whether the differences bother you rather than the need to have perfect symmetry. Speak to your plastic surgeons about small procedures to create more symmetry of the nipple and areola.