4.5 months post op, my breast started to dropping too low. Do I need a revision?
Appears as mild "bottoming" but not unattractive. If you desire higher position the revision with ACD matrix (costly) is the next step...
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Implants too low?
Based on your photos, it does appear that your implants are sitting slightly low -- much of the implant is sitting below your nipple and your incisions (and your inframammary fold) have ridden up onto your lower breast. Given that you are 4 1/2 months post-op, you may still see more settling which would make matters worse. At this point I wouldn't recommend any surgical intervention, and if your implants stay where they are you may be fine with the shape. If they settle more, however, you could be a candidate for a capsulorrhaphy to reposition the implants into a more ideal position. Follow up with your Plastic Surgeon to be sure.
Going braless is up to you, as I don't think it has much to do with long term implant position.
Your implants look to sit a little low however you result is satisfactory. You have a tight chest with a decent sized implant. A high profile was the right choice however the volume may be too much for your body to handle. If you both agreed on the this at your consultation then I think your result is as good as it is going to get. I would continue to wear your bra for support for the next 3-6 months to allow the capsules to mature.
Slight bottoming out
Thank you for your pictures. You should never really go braless for an extended amount of time especially with implants. The way to the implant will change a result if you go braless for extensive periods of time. Your implant seem to be slightly bottomed out. The revision is really up to you and how you feel about the shape and size are your breast. I would definitely consider it to more evenly distribute the implant ball you above and below your nipple.
Your problem is not simply bottoming out
Your result is good and is in line with your pre photo. Your nipple is high set on your breast in the preop photo and is high set post op. Initially the swelling of the upper pole which is more common with sub muscular augmentation may appear like bottoming out when the swelling goes down but really is the shape of the implant. Only your plastic surgeon can tell if you are really bottoming out. One possible way to address this may be to use a wider implant which would fill up higher on your chest making your nipple be more centered on your chest. Based on the position of your scar it doesn't appear that your implant has migrated lower on your chest. Your plastic surgeon can figure this out based on your measurements. As always, a proper exam and better photos would allow for a more accurate analysis.
It looks like in the photos that your implants have descended pretty low. An internal capsule repair +/- strattice to reinforce it may be necessary.
Bottoming out of breast implants at 4 months after breast augmentation
Thank you for your question. Based on your photograph your implants do appear to be bottoming out. Please see your plastic surgeon for an opinion. An internal capsulorrhaphy can be done to tighten the lower pocket and elevate the breast implant.
For more information on revision of breast augmentation please read the following link:
Early bottoming out
It appears as if you are having some early signs of bottoming out. The distance from the nipple to the breast crease is a bit elongated indicating that either your skin is stretching or that the implant is descending too low on the chest wall. You would probably be well served with a capsulorrhaphy procedure to help re-establish and stabilize your original breast crease.