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Now 9 Months PO, Noticed "Bottoming Out" at 4 Mo PO, I Approached my Dr. and He Totally Denies This. What To Do? (photo)

asked 4 months ago by droopyDD in NJ
Latest answer by Armando Soto, MD
Question viewed 226 times
Tags: 9 months post-op, bottom out, options

Had BA 4/11, had bottoming out 4 mo PO with stretch marks. I am now 9 mo PO couple months ago had PO visit surgeon denied this, but did not take measure. or allow me to lie down to show him, he insisted on the 550 cc. When I lay down they're at my armpit,even with a bra no cleavage.He blew me off, told me i am just an unhappy person told me to come back 3 mo, I've consulted w/ another Dr. who totally agreed, but don't feel i should have to pay $9k to fix.My next PO visit is March.What to do now?

11 answers to Now 9 Months PO, Noticed "Bottoming Out" at 4 Mo PO, I Approached my Dr. and He Totally Denies This. What To Do? (photo)

+1

Bottoming out versus asymmetry to begin with.

Based on the preoperative photos you provided, your folds were uneven to start with and you had a degree of asymmetry with more overhang of the left breast. The right breast fold is lower than the left. Unfortunately, the photos from 1-2weeks and 4 months are a bit deceiving because of the arm position and how it changes the appearance of the breasts. Still, you have very large implants and you have some bottoming out or "pseudoptosis" in both breasts. The cleavage issue has... more
David Bogue, MD

Boca Raton Plastic Surgeon

www.drbogue.com

+1

Bottoming out with large implants - what to do??

There are several issues here which are not in your question. What was the cup size or implant you desired? How was the implant size determined? What are your measurements: base width, tissue compliance? I can see from your photos that there is obvious stretching. Stretch marks are visible and appear worse with time. If I assume that hte original incision was in your crease, you can see inferior migration of the inferior mammary fold. All this is characteristic of lower pole... more
Mark D. Epstein, MD

Stony Brook Plastic Surgeon
+1

Plication required for bottoming Out

Your pre-operative photographs show that your breasts are low on the chest wall and you have very little cleavage. your after photographs show the implants are much too large and have stretched the pocket and descended inferiorly laterally. You need these large implants removed since your body cannot support their weight and replace with smaller ones. At the same time, you will have to undergo capsule plication laterally and inferiorly which will elevate the implants higher... more
Gary M. Horndeski, MD

Houston Plastic Surgeon
+1

Now 9 Months PO, Noticed "Bottoming Out" at 4 Mo PO, I Approached my Dr. and He Totally Denies This. What To Do? (photo)

Thanks for the photos. Very tough situation, where your chosen surgeon has abandoned you in a degree. But your result though not perfect is acceptable to a degree. If you desire improvement than yes additional surgery is a fee for service issue. I believe your first surgeon will not assist you in any way, with $ or explanations. I guess best to move on. Sorry.
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Revisionary Breast Surgery

Before you had surgery you had widely spaced breasts and your left breast was larger and lower than the right. The second photo shows a reasonably good result. Your implants were likely placed under the pectoralis muscles. These are diagonal muscles that run in a diagonal direction ( like the hand you place over your heart to say the Pledge of Allegiance). When those muscles contract they apply a force on the implant that is perpendicular to the length of muscle which... more
Lori H. Saltz, MD

San Diego Plastic Surgeon

www.ljcsc.com

+1

Breast augmentation issues

It does look like your implants have bottomed out a bit at this point. Everyone reacts differently to the surgery. The best thing to do is sit down with your doctor and try to figure out the best way to satisfy you. If it means surgery to lif the fold maybe even use a smaller implant then that is what shoudl be done. You will probably have to pay for the facility and implants and +/- surgeon's fee. Everyone is different.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Bottoming out after 4 months BA

You clearly have some asymmetry issues which you had before surgery. In spite of this it looks like your right implant has shifted a little too much down and out. It might be in part because of the relatively large size of the implant. 4 months is still relatively early and you might be able to help by staying in a good support bra 24/7 for 6-8 weeks. At least it will help prevent it from getting worse and buy you time while you consider whether or not you really want a revision.... more
Ronald Schuster, MD

Baltimore Plastic Surgeon
+1

Is revision necessary for asymmetry

We can see the difference in the fold left to right, however is the problem great enough to have a revision. The fold will always rise a bit as you show in the photo, and overall he result is not too bad. Implants are large but might have been what your wanted. We too would suggest you give things more time. Best of luck, peterejohnsonmd.com
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Revisionary Surgery and Communication with Surgeon?

Thank you for the question and pictures. Based on your pictures and description, I think you may be experiencing bottoming out and lateral displacement of the breast implants. The good news is that the situation is correctable using internal sutures ( capsulorrhaphy). Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. This is... more
Tom J. Pousti, MD

San Diego Plastic Surgeon

www.poustiplasticsurgery.com

+1

How to approach your surgeon when you're not happy

Hi there- As all of my colleagues have mentioned, and I am sure you are aware at this point, your breasts were fairly uneven before surgery, and so without a more significant intervention, it would not have been possible for your breasts to be perfectly even after a breast augmentation. Nor is it reasonable (again, without a more significant intervention) for you to think that your breasts can be perfectly even with a minor revision at this point, no matter who does the... more
Armando Soto, MD

Orlando Plastic Surgeon
+1

Who Pays for Breast Revision Surgery

Here is how I would answer your concern, and it is definitely not a black and white issue. You have photos at two weeks that look fine. You have photos at 4 months that show obvious bottoming out with additional lateral displacement. What procedure did your doctor perform on you between those two dates, ie 2 weeks and 4 months after the original surgery. I suspect no procedures were performed. But it sounds like you are holding your doctor responsible for how your body reacted to... more
Ronald V. DeMars, MD

Portland Plastic Surgeon

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