How Should I Proceed if the First Repair of Bottoming out Was Not Successful?

I am 5'7 & 140lbs after having lost about 125 lbs. I had a tummy tuck and a breast augmentation with silicone moderate profile (659cc) under muscle 7 mths ago. Two months later I began running with excellent bra per doctor's approval. I bottomed out. I had revision surgery almost 2 months ago. My capsule was reinforced with the muscle folded extra for added sucture strength. I have bottomed out again. What would you suggest? In addition to smaller implants, is a lift needed to reinforce it?

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7 Doctor Answers | Asked by bottomedout in Shakopee, MN

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Repeat bottoming out of breast implants

I would suggest you consult with a surgeon experienced in the use of Strattice to reinforce the pocket and hopefully resolve your problem.

Correction of Bottoming Out?

Thank you for the question. it would be in your best interest to seek consultation with a board-certified plastic surgeon well-versed in revision a breast surgery. Correction may involve capsulorrhaphy and/or use of acellular dermal matrix. Best wishes.

Correction Of Bottoming Out

As usual it would be easier to provide an answer to your question if you had included a photo. Your primary problem as you somewhat alluded to is the fact that your implants are too large which greatly increases the chance for problems. The other thing that you might consider would be the use of Stratice or another ACD, but that will add significantly to your cost.

Bottoming out after breast augmentation

I generally repair the bottoming-out with suturing of the capsule first. To date I have seen no recurrences with the current technique I've used over the past several years. Prior to adopting this current technique, I saw many recurrences in both my patients and other surgeons' patients with previous suture techniques. If bottoming out ever recurs after this first repair, I recommend proceeding with a Strattice repair. I currently use this approach since I've seen no... more

Bottoming Out After Breast Augmentation

It is difficult to evaluate "bottoming out" without photos, but if it occurs soon after surgery it is generally because of one of two possibilities. Either your skin has poor elasticity or the implant is too big and heavy. In your case it is probably both reasons. Most massive weight loss (more than 100 lbs.) have had the skin, including the breast, stretched out and will not support a heavy implant. Also, a 650 cc. implant is going to be heavy for anyone. Strattice, in internal sheet of... more

Bottoming out again--3rd operation pending.

Congratulations on your weight loss! The loss of elasticity that accompanies major weight loss (and aging) leaves skin that has less tensile strength, a higher likelihood of recurrent thinning and stretch, and (particularly with larger, heavier implants like yours) more potential for bottoming out. In many cases, "planning" for this and anticipating a certain degree of implants "dropping" into position can help to avoid or reduce this occurring, but in all honesty, I... more

Strattice for repair of breast implants bottoming out

Breast implants can sag if there is inadequate support, which is called bottoming out or lower fold malposition. Strattice, a type of acellular dermal matrix, is sort of like an internal bra that adds support.