2 months post op, 300cc implants under the muscle. Are My Breast Implants Bottoming Out? (photo)

I'm 2 months post op and went from an A Cup to a C Cup, getting 300cc implants under the muscle. I've been very concerned that the implants seem to be sitting very low and rippling at the side of my right breast. I am posting before and after pics for you to have a look at. I went back to my surgeon and he said I had very little breast tissue and as far as he is concerned this is still a good result and recommends that I put on some weight. I asked him if he lowered my crease line, he said no

Doctor Answers (10)

Breast implants bottoming out?

+2

At least in the right side on the photo, the breast does look a bit our of sorts. There appears to be the implant below the fold or the lower pole not properly exapnded around the implant. This may require correction. Give it a few months to settle a bit more.


Manhattan Plastic Surgeon
4.5 out of 5 stars 16 reviews

Bottoming Out after Breast Augmentation?

+2

Thank you for the question and pictures.

Although I hesitate to second-guess your plastic surgeon (who knows your situation best) I would have  the same concerns that you do about the potential for breast implant displacement ( “bottoming out”).   Of course, given that you are only 2 months out of the procedure, it is too early to evaluate the end results of the procedure.

Based on your frontal and side view photographs, it seems to me like the breast implants may be sitting relatively low on your chest wall in  relation to the position of the nipple/areola on the breast mounds. In other words, the nipple/areola complexes seem to be pointing upwards,  suggesting that the breast implants are sitting relatively low.

 At this point, I would suggest that you continue to  follow-up with your plastic surgeon. Continue to communicate your questions/concerns.  Evaluate the end results of the procedure several months from now.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 701 reviews

Are My Breast Implants Bottoming Out?

+1

Sorry for your experience. But yes you will need some type of revision. Best to obtain a few in person evaluations from boarded PSs in your area. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

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Are My Breast Implants Bottoming Out?

+1

By looking at various skin markings in the photographs, it does appear that your implants are below your natural inframammary crease.  This situation can occur by dissection of the implant pocket below the fold at surgery or by descent as a result of gravitational or muscular forces.  In patients with a tight crease, this situation can lead to an unnatural indentation in the lower pole of the breast called the "double bubble".  The nipple areolar complexes are pointing slightly upward which is another indication that the implant position is lower than desired.

Your implants appear to be high profile implants.  This means that the base diameter is relatively narrower and the projection is higher.  This can result in a more spherical look to the breasts.  Your implants are so projecting that they almost look like overfilled saline implants.  A relatively wider based implant (moderate profile) will give you more upper pole fullness.  This would lessen the appearance of the implants being too low.

I would discuss these concerns with your surgeon.  He knows exactly what was done during your surgery and can make recommendations to address your concerns.  I would wait at least 3 to 6 months after your initial procedure before I would consider revision surgery.

Philip E. Fleming, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 1 review

Breast Implants Bottoming Out at 2 Months

+1

   The implants do appear to be sitting low, but I would wait at least 3 to 6 months before considering a revision.  I would also make sure that the breasts are soft and do not have capsular contracture.  However, most cases of capsular contracture cause the breasts to lift not drop.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 191 reviews

Implant position

+1

I agree with the previous surgeons. Another thing to consider is that you must avoid weight training with your pectoris (chest) muscles. Forceful contractions of the pectoral against large resistance causes the implants to be pushed downward and outward which exacerbates and promotes implant malposition. We show our patients how to isolate their muscle groups without increasing the likelihood of malposition and or displacement. 

Larry C. Leverett, MD, FACS
Phoenix Plastic Surgeon
5.0 out of 5 stars 4 reviews

Revision breast augmentation works.

+1

Hi.

1)  I am afraid that you are right.  They don't look great. A little bottoming out.  Do nothing for four months, but I don't think they will change much. Eventually you may want a revision.

2)  Before surgery, your right nipple pointed outward.  That needs to be addressed.

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

Too low?

+1

Hi,

i agree with the other plastic surgeons here. your implants seem a little low but it is still early. also, based on the photos, your implants look more OVER the muscle than UNDER. from the side view, the pectoralis should be lifted over the implant but it looks like it's not.

do the implants move well? if you tense your chest muscles, does the implant deflect down or not move much at all? 


I really don't think that gaining weight will help the position of the implant, but it is a good idea to let this heal more before considering any type of revision. 

Hope that helps. 

 

 

Bennett Yang, MD
Rockville Plastic Surgeon
5.0 out of 5 stars 8 reviews

Are My Breast Implants Bottoming Out?

+1

Based upon the photos, it does appear that the nipples and areolas are positioned too high on the breasts and implants, and that the bottom of  the implants may be lower than the breast folds, although I can't quite make out the incisions in these photos. Another possibility is capsular contracture--do these implants feel abnormally firm?  

Wearing some firm underwire support may prevent further bottoming out. When massaging avoid pushing downward. Follow up with your surgeon. It is still early. 

 

Thanks for your question and for the posted photos. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Bottoming Out

+1

It is never the same as seeing the patient in person but based on these pictures it appears the implant is a bit low.  The rippling issue has more to due with the implant and lack of soft tissue.  It also appears that you have high profile implants and maybe moderate plus would have been a better options.  Return to your surgeon and have them address your concerns.  You may also want a true second opinion.

Gary A. Tuma, MD, FACS
Princeton Plastic Surgeon

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.