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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?

Asked 37 months ago by inquirer in Philadelphia, PA USA
Sort 11 expert answers by:
+3

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

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.
Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
+3

When to call the surgeon

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... more
Steven H. Williams, MD
San Francisco Plastic Surgeon
+2

Slight bottoming out after breast augmentation.

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
Manhattan Plastic Surgeon
+2

What did you start with?

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... more
Otto Joseph Placik, MD
Chicago Plastic Surgeon
+2

Yes, but mild

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!... more
York Jay Yates, MD
Salt Lake City Plastic Surgeon
+2

Yours is borderline

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
+2

Not technically bottoming out...

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... more
Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
+1

Bottoming out

Bottoming out is when the implant falls below the natural breast fold.  It is always good to review your pre-op photos to check the position of your areola on the breast mound. You may have slight bottoming out but certainly within acceptable range. I probably would leave them alone.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Inquiring minds want to know

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
+1

It appears you have a very slight case, at least on the left.

Overall, your results look good. It does appear that you have a very slight case of 'bottoming out' at least on the left breast. Definitely talk with your surgeon to understand your options. It may be too early to have a corrective surgery, but you will want to get advise on precautions & find out what your surgical options are for the future.
Thomas T. Nguyen, MD
Orange County Plastic Surgeon
+1

Breast implants bottoming out - A matter of opinion

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... more
Richard Baxter, MD
Seattle Plastic Surgeon
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