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Internal Stitches to Prevent Bottoming out - Normal?

asked 11 months ago by aprildawnxo in Toronto, ON
Latest answer by Richard Linderman, MD
Question viewed 514 times
Tags: bottom out, internal, normal, stitches

My PS told me after I woke up from my first BA that he put in internal stitches in to prevent bottoming out, is this common for doctors to do? Thanks so much for any answers!

14 answers to Internal Stitches to Prevent Bottoming out - Normal?

Breast Augmentation - Sutures to Prevent Bottoming Out?

Hi aprildawnxo, It may or may not be normal - but it sounds like it was a good thing to do in this case. It is hard, of course, to make a comment without seeing what you looked like before. And I'm assuming that this was a primary breast augmentation (ie, it was not a redo. In secondary - revision - breast implant surgeries, it is a lot more common to use sutures/stitches such as these). As far as I know, most surgeons do not use such sutures as part of primary... more

Alan Engler, MD
New York Plastic Surgeon

Bottoming Out in Breast Augmentation

The answer would depend on what your plastic surgeon meant by "bottoming out". If he or she placed internal stitches to prevent the breast implant from drifting below the breast fold, it sounds reasonable although it is probably not necessary to use permanent stitches because once the pocket and capsule have formed things should be stable. However, the "bottoming out" that occasionally occurs through stretching of the skin and soft tissues of the lower part of the breast... more

Joseph Fata, M.D.
Indianapolis Plastic Surgeon

Bottoming out after breast surgery

I personally do not use any sutures to prevent bottoming out (nor do I know any colleague who does) and do not particularly believe in them. However, I have no doubt that your surgeon did what he thought was best for you at the time of the operation.

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon

Sutures for Bottoming Out

Bottoming out or stretching of the lower pole of the breast in usually seen after previous breast implant surgery. Photos would certainly be helpful but I am unaware of surgeons placing sutures in a primary breast augmentation to prevent this problem. Avoiding this problem by not placing the implant too low and choosing the appropriate size implant is the best course. Are you happy with the way your implants and your surgeon? If the answer is yes, then do not worry. more

Richard Linderman, MD
Indianapolis Plastic Surgeon

Internal Sutures and Bottoming out

I have used internal sutures to correct bottoming out. Sounds like your surgeon was doing something else. Like the rest of the panal has stated, if you look good and have no issues, you should not worry about it. Enjoy your results.

Tom J. Pousti, MD
San Diego Plastic Surgeon

Sutures for bottoming out

Some surgeons pale sutures in the pocket to maintain a specific size, and also maintain the fold. I do not routinely place internal sutures in the pockets of primary ( first time surgeries) breast augmentation patients.

Steven Wallach, MD
Manhattan Plastic Surgeon

Bottoming out

I am not aware of internal sutures placed propylactically. i am not sure what the surgeon would be sewing. if they look fine dont worry about it

Jonathan Saunders, MD
Newark Plastic Surgeon

www.drjonathansaunders.com

Bottomong out of breast implants

Most plastic surgeons do not use sutures to prevent bottoming out in a standard breast augmentation, although some do. The chances of bottoming out of implants can be reduced by not over dissecting the region of the lower breast fold.

David A. Bottger, MD
Philadelphia Plastic Surgeon

Internal sutures to prevent bottoming out?

Although I do not use internal sutures to prevent bottoming out in most primary cases of breast augmentation (where they are usually not needed), there are surgeons who do. There is no right or wrong approach. Those surgeons who do not use them try to control bottoming out by accurate pocket dissection and post-op bras. Those that do add one or more internal sutures as "insurance" against bottoming out...they may work, they may not. But if your results are... more

Robert M. Grenley, MD
Seattle Plastic Surgeon

Bottoming out with breast implants

I have never placed internal sutures to prevent bottoming out. I have used them to CORRECT someone who has already bottomed out. I assume that you are not having a revision? As previously stated in this post, a lot of us do things differently and there is rarely a "right" answer. As long as they look great then I wouldn't worry about it. Good luck!

Tiffany McCormack, MD
Reno Plastic Surgeon

www.plasticsurgeryrenotahoe.com

Preventing a bottomed out breast implant

It is not usual to place sutures at the time of breast augmentation to prevent a bottomed out breast implant. In fact, bottoming out is not a particularly frequent problem for most surgeons. The key is accurately forming the implant pocket, and holding the implant within with a snug bra for several weeks after the procedure. If the sutures help your surgeon set and fix the lower extent of pocket, so be it. Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Internal Stitches

It really depends on your anatomy. Since you did not provide any before and after pictures and we are not examining you in person, it is impossible to give you specific advice. However, if your results look ok, then there is nothing to worry about. If you have concerns, then you should address these with your surgeon. Good Luck.

David Shafer, MD
New York Plastic Surgeon

Preventing bottoming out of breast implants

Your own doctor was there but I'd have to say that in 25 years,, I have not resorted to using internal sutures at the time of primary augmentation. I do use a strong underwire bra 24/7 for 3 months after the surgery to prevent bottoming out in patients at risk. So maybe the internal stitches will work for you. If you look good, don't worry - every surgeon needs to do what their best judgement tells them is the optimal thing to do.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Internal Sutures and Bottoming Out - Always Necessary?

Internal sutures are not necessary on every patient. Actually, it is quite the opposite. The majority of women undergoing breast augmentation do not need any sutures at the time of their augmentation. However, there are some women who may benefit from placing them at the initial surgery - women who have no real natural breast fold where you are trying to create and stabilize that fold, or women who are having larger implants placed that may pull on the tissues over time... more