I had my BA two months ago. (330, silicone, super high profile, submuscular, infra) Now I know my breasts have bottomed out. The doctor said he would expand the pocket (upper pole) and he could take some skin bellow the niples too. Since the silicone is lower than the position it should be, if takes off this skin, the breast will go down instead of the silicone going up, Am I wrong??? What should be done so it would look better??
Need To Redo BA w/ Silicone After Bottoming Out, Any Advice? (photo)
Doctor Answers (5)
Bottoming out after augmentation
I don't believe you need any skin removal, simply a repositioning if your implant.
Advice for correcting bottoming out implants
There are many factors that can contribute to implants bottoming out, which is when they settle too low. What all factors have in common is that the tissues on the lower part of the bresat are not adequate to support the implants. Paradoxically, going under the muscle can make it worse since the muscle pushes down from above but doesn't add support from below. What I see in the pictures is a very tight skin envelope relative to the size of the implants so it will be wise to heal some more before having another procedure. You may benefit from a Strattice garft for a living internal bra.
Revision breast augmentation
Thanks for the question and the pictures. It appears that you have bottoming out and this requires surgical intervention to repair. In addition to suture techniques which close the inferior aspect of the pocket to push the implant back up into its proper position, I often use Strattice. It's a collagen matrix that provides a great deal of strenght to the repair.
You may want to wait a few months to allow for the swelling to decrease a little more, and the capsule to form a bit more in order to have the best tissue to repair. In the meantime, wear a supportive bra to prevent further downward movement.
I hope this helps.
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The photos are not that conclusive, but if you do have bottoming out, then the support along the fold has been compromised and would need to be corrected often with suture techniques and capsule manipulation.
Bottoming Out Correction?
Thank you for the question and pictures.
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.
In my opinion, bottoming out his best corrected by “raising” the inframammary fold using internal sutures ( interior capsulorrhaphy). This is done after careful measurements are made from the areola to the “new” inframammary fold. Removal of skin below the areola is not necessary in my opinion.
I would suggest that you confirmed that your surgeon has had significant success in the past with similar patients.
I hope this helps.