Do You Think my Left Breast Implant May Be Bottoming Out? (photo)

surgery date april 26 2012 approx 3 months post op now and it seems like my one breast is looking at you and ones looking for ya if you know what i mean. I know i wasnt symmetrical before but im feeling a bit self conscious now. so im wondering if i have a valid concern to bring up to my surgeon?

Doctor Answers (7)

Kudos To Your Plastic Surgeon

+2

YOU ARE NOT BOTTOMING OUT ON THE LEFT.  Pre-operataively, your left breast was higher than the right.  Your left inframammary fold was also higher than the right.  Your plastic surgeon lowered the inframammary fold on the left which allowed your implants to be at the same height.  Unfortunately, since your left nipple was higher than the right to start with, and when you lower the fold, the nipple turns slightly upward.  Had he not lowered the fold, your left nipple would still be higher than the right because it always was, and the top of your breast on the left would have been higher than the right.  It would have looked funny to anyone seeing you at the beach, in a halter top, or even in regular clothing.  Therefore, your surgeon did the right thing.  The only time your nipples are going to be seen is when you are undressed and hopefully you have a supportive mate.

The only criticism that I could level at your plastic surgeon is that either he or she apparently didn't give you a sufficient explanation of choices, or he or she may have discussed it with you, but you get so much information pre-operatively, you may have heard it but not processed it.  All that being said, congratulations on a great result.


Honolulu Plastic Surgeon
5.0 out of 5 stars 191 reviews

Breat Implants Settling Into Natural Position

+1

Hello,

Based on your photos, it does not seem that your breasts are bottoming out; your implants are settling within their natural pockets. 

Before your surgery, you had breasts asymmetry but when you had your breast augmentation and the size increase did occur the asymmetry was accentuated a little. Lowering your inframammary fold of your left breast did help a lot; had your surgeon not done so you will be unsatisfied with your results.

All in all, I believe that gravity is taking its natural course and you should be a little more patient allowing the final results of your surgery to get established. Only then you will be able to assess the final outcome of your breasts augmentation.

Meanwhile, I recommend that you follow your surgeon's instructions religiously and keep him/her in the loop of your progress.

Congratulations on your results.

The best of wishes to you.

Thank you for your post and sharing your photos.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 115 reviews

Bottoming Out after BA

+1

From your photos it does not appear that you are bottoming out.  You had some suttle differences in your breasts before surgery that now may seem more apparent to you.  For example, your left nipple was slightly higher than your right pre-operatively, and remains this way after surgery. Your surgeon did lower your left inframammary fold to adjust for this which was a good idea. If this still concerns you I would recommend following up with your plastic surgeon. I hope this helps.

Kindest regards,

Neil J. Zemmel 

Neil J. Zemmel, MD, FACS
Richmond Plastic Surgeon
5.0 out of 5 stars 48 reviews

Bottoming out breast implants

+1

It appears as though your implants are settling into their natural position, not true "bottoming out."  If you still have concerns in several more months, check with your plastic surgeon to make sure your implants aren't moving out of their natural pocket.

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 68 reviews

Postop

+1

There are differences between your breasts. There were present before surgery and implants alone do not fix those problems. Maybe suboptimal communication between you and your surgeon. I would have pointed this out extensively. Your results are good given your preop issues. It still may be possible to improve them. Discuss it with your PS

Michael Hueneke, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 23 reviews

Bottoming out of breast implants

+1

Before surgery, your left breast crease was higher than your right. It appears as if your surgeon attempted to lower the left breast crease and was a bit aggressive. It now appears that the left is lower. This is a common problem seen when the inframammary fold is tampered with. My guess is that your implants are in the subglandular space instead of under the muscle which might be complicating the issue. I do not think that this is going to resolve on its own and will likely just continue to progress with time. I think you need to talk with your surgeon about your options which will likely involve a revision surgery. Best wishes. 

William T. Stoeckel, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 37 reviews

Bottoming Out of Breast Implant?

+1

Thank you for the question, pictures, and colorful description of your breasts' appearance.

 Based on your pictures,  breast asymmetry and the lower position of the left breast implant is clearly visible.  I think you have a “valid concern” to discuss with your plastic surgeon. However, I would not suggest revisionary breast surgery at this point, in my opinion, it would be best to wait as close to one year postoperatively to  evaluate the final position of both breast implants.

Generally speaking, bottoming out involves inferior migration of breast 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 corrected by “raising” the inframammary fold using internal sutures (capsulorraphy). This is done after careful measurements are made from the areola to the “new” inframammary fold.

You may find the attached link helpful.

Best wishes.

 

 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 702 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.