Surgeon Says I Bottomed out on Right Side? (photo)

I went for my 3 month post op yesterday and the surgeon said I had bottomed out on the right side. I had noticed that the incision scar was higher up on my breast on the right than the left but I had just attributed this to as symmetry before surgery. He wants me to wait until a year and than have the procedure done with the permanent sutures. My question is if I opt to not have anything done will it just stay the way it is ( I can probably live with this) or what could happen to it?

Doctor Answers (14)

Bottoming out

+1

Hi, the right side has definitely bottomed out.  If it doesn't bother you just leave it.  If it bothers you have it fixed.   I don't believe that 1 year is necessary to wait.  Discuss with your doctor , I am sure he can help.    Good luck! 


New York Plastic Surgeon
4.5 out of 5 stars 16 reviews

Breast Revision for Bottoming Out

+1

   The right breast has bottomed out, and a capsulorrhaphy or pocket revision will need to be performed to lift the implant back to improve symmetry.  Kenneth Hughes, MD HughesPlasticSurgery, Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 179 reviews

Breast implant down.

+1

Thanks for your post and photos. Yes, the breast implant on the right is lower than the natural crease. This can be improved by closing off that part of the pocket, but will not get better on its own. It is possible that the breast implant may continue to descend a bit and it is reasonable to wait a while before choosing to have a revision. Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 121 reviews

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Bottoming out

+1

You do appear to have an implant that has bottomed out on the right.  If you can live with the asymmetry, then do so.  If it worsens or becomes bothersome, it can be repaired surgically.  Best wishes!

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Hello

+1

 

If it doesn’t bother you and you can live with the asymmetry then do so. Make sure you wear a supportive bra as much as possible. Without picture it’s very hard to give you better advice.

 

Stuart B. Kincaid, MD, FACS
San Diego Plastic Surgeon
4.5 out of 5 stars 7 reviews

Yes, breast implant has descended below breast fold

+1

Hello,

Thank you for the question and photo.  The breast implant on that side has descended below the breast fold.  Nothing bad will happen if you choose to not have it repaired other than the asymmetry that you see.  Correcting the issue will require repair of the breast implant capsule.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 81 reviews

Surgeon Says I Bottomed out on Right Side?

+1

I would not wait but revise now at 4 to 6 months post op. Not a good idea to have no attempted correction. 

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

Did My Implants Bottom Out?

+1

Bottoming out can occur for several reasons after breast augmentation surgery.  The first is the inherent strength of your tissues.  There are genetic differences to collagen composition in patients which can affect healing and tissue stregth.  Weight loss surgery patients are also somewhat at risk as a result of the stretching of tissues and nutritiional imbalances that can affect healing.  Using an implant that is too large for your skin envelope and body size can also put you at risk for this procedure.  Finally, release of the fibrous tissues of the fold can also increase this risk. At 3 months your results are most likely stable.  If you are comfortable with the outcome, avoiding the cost and discomfort of reoperation is always desireable.  If not, correction is fairly routine with capsulorraphy suture and reinforcement in some cases.  Discuss these options with your surgeon.  Thank you for the question and good luck!

Robert F. Centeno, MD, FACS
Fairfax Plastic Surgeon
5.0 out of 5 stars 25 reviews

Bottoming out after breast augmentation

+1

Thank you for your question and for providing the photos. It does look like you have bottomed out a bit on your right side, which can happen after a breast augmentation. If the skin doesn't have the strength to support the additional weight of the implant, it can decend and "bottom out". If a capsule develops that is thick enough to provide additional support to the skin, your implant and pocket may stabilize and no further bottoming will occur. If this does not happen, you will have further thinning of the inferior pole and further descent.

The question of whether to repair this is a personal one. If it does not bother you, then there is no reason to correct it. You could wait and see if any further bottoming develops before making this judgement. Typically, this is corrected with the addition of support of the inferior aspect of your breast by placing an acellular dermal matrix sling. This can give a more predictable correction than simple sutures or pocket correction.

I would suggest diiscussing your result with your plastic surgeon. They will be able to provide additional thoughts after examiningyour breasts.

Best of luck.

Jeff Rockmore 

Jeffrey Rockmore, MD
Albany Plastic Surgeon
5.0 out of 5 stars 24 reviews

Surgery or not?

+1

Yes, it does look like you ahd some bottoming out. You probably need a pocket revision to even them out.  Your choice.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 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.