How Can You Tell if Your Breast Implants Bottom Out?

Dear Doctors, I've had a slight concern about my nipple and whether it sits slightly high on my breast mound. It has been 6 months post op. I'd like to have your professional opinion on whether you think my breast implants have bottomed out.

Can you tell just by looking at the implants whether they are bottoming out, or are there other considerations? How do you know when it is time to call your surgeon?

Doctor Answers (12)

The distance between the bottom of the areola and the inframammary fold determines if an implant is "bottoming out".

+5

In a "C" cup breast, the distance from the areola to the crease is about 6 cm (3 inches), slightly more for "D" cup.  If the distance in 2 cm or so longer, the volume of the breast will appear well below the horizontal axis.  This is most commonly seen in submuscular implants where the vector of the pectoralis muscle pushing on the implant stretches the capsule and creates this problem.


Atlanta Plastic Surgeon
4.5 out of 5 stars 8 reviews

Slight bottoming out after breast augmentation.

+4

Hi.

1)  You have slight bottoming out in the left breast after breast implants, but overall, you look quite good.

2)  I would recommend leaving them alone, unless you really dislike them.  But remember, perfection is the enemy of good.

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

When to call the surgeon

+4

The time to call the surgeon is anytime after surgery and you have concerns.

As Dr. Baxter points out there is some amount of judgement based on the pictures you're presenting. It is difficult to say specifically without seeing your pre-operative pictures as well.

I would say that your inferior pole (the under portion of your breasts) seems a little full. Whether the average person would find this unattractive may be a point of discussion.

As always - the best way to address concerns post-operatively are to see your treating plastic surgeon or make an appointment to see a board certified plastic surgeon.

I hope this helps.

Steven H. Williams, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 23 reviews

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What did you start with?

+2

Your result is certainly within the range of normal.

My question is what did you start with? Was this the general appearance of your breast but only smaller?

IF the answer if yes then, I would not be concerned at all.

IF the answer is no, then the next question I would ask is if it has gotten worse over the past 2-3 months.

IF it has gotten worse, I would be concerned and consult with your plastic surgeon

IF it has been stable, I would make sure that the vast majority of bras you wear are supportive bras (padded underwire) and you may want to wear them at night to prevent further aggravation of the lower pole expansion.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Yes, but mild

+2

In the photo you have submitted, the right shoulder is a little higher than the left yet the right implant is sitting a little lower. The right implant also seems to have bottomed out a little more than the left. It may certainly be the camera angle. That being said, the asymmetry is fairly mild and the degree of bottoming out is mild as well. My opinion (based on a single photo alone) would be to revise it only if it is very bothersome to you. Sometimes the enemy of good is better!

York Jay Yates, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 41 reviews

Inquiring minds want to know

+2

Dear Inquirer,

There is a wide range of results from breast augmentation surgery. Yours is certainly well within acceptable and trending toward good, if not very good. The real self.com question is do you like it? If you are displeased with the result discuss it with your plastic surgeon. He/she can explain your options and any further consequences that you may incur. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 31 reviews

Yours is borderline

+2

Larger fuller implants are heavier and more prone to bottom out. Yours look like they might have a slight downward displacement but not drastically so. If they were put in through the crease, you would see your scar riding up higher onto the lower pole of the breast. This can be a tipoff of bottoming out. Unless you are unhappy with your current result, there is no need to do anything because yours is mild.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 48 reviews

Not technically bottoming out...

+2

Although your nipples appear north of the equator of the implant or mound of your breast, whether or not this is attractive is a matter of opinion and taste.Some patients prefers and some might think the implants are too low (nipple too high). Bottoming out usually refers to a long-term effect of inferior displacement, loosening,or sagging to the bottom part of the breast. This is also a term we use in breasts without implants after a reduction or lift where the breast tissues loosens and falls too far below the nipple.

You might discuss this with your surgeon as to whether the position of the implant is in the location he and you intended them to be, or if are they lower than intended. Sometimes the relationship between the implant, the nipple and the bottom of the breast is hard to accurately predict because it is a dynamic operation of sorts where things move around a bit and tissue stretch.

In the end it is not so important if you call this bottoming out, displacement, or malposition. The question is: is it bothering you enough to want to do something about it?

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 7 reviews

Breast implants bottoming out - A matter of opinion

+2

In general, bottoming out is when you see more breast below the nipple than above, taking into account that too much fullness in the top portion is not a natural look.

If you imagine the outline of the implant forming a circle, ideally the nipple would be in the middle most of the time. From your pictures, some would deem them to to be attractive, others would call it bottoming out.

My sense is that there is some bottoming out, though whether it is enough to justify additional surgery depends upon your preferences.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

Implants Bottoming Out

+1

Overall, I believe most people would consider the results of your breast augmentation surgery to be excellent. There appears to be minimal settling of your implants and minor asymmetry, but these changes are within the normal acceptable range and don’t justify surgical revision.

 

         Evaluation of your pre-operative photos may demonstrate baseline asymmetry that was present prior to surgery. If you have anxiety about your situation, consultation with your surgeon would be appropriate.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 76 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.