Wanting to Go Bigger, How Do I Avoid Bottoming Out? (photo)

I'm a 5'0 96lb Asian. I am currently 8 weeks post-op and have 350cc round high profile partial unders inside me. I was told last week by my doctor that I have bottomed out. I do wish to go up to 450cc when I have my revision but I'm worried I might bottom out again. What should my surgeon do to avoid this? And what should I do as well? Should I wear an underwired bra right after my revision? My incision will be under the crease again.

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5 ft 0 in to 5 ft 3 in 350-399cc 2 months post-op 090-109 lbs bigger bottom out high profile prevention

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11 Doctor Answers | Asked by gorgydoc

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Wanting to Go Bigger, How Do I Avoid Bottoming Out?

Revision of the infra mammary area with ACD matrixes and capsularraphy is my recommendation. As to size 500 UHP cc my choice.

Implants and Bottoming Out

Hi, At 8 weeks post-op and based on your pictures, I don't think it is a certainity that you have "bottomed out". However, with your petite body frame, reaugmentation with larger implants will increase the chance of bottoming out (or make it worse). In my opinion, you should allow settling for at least another 6 months before deciding on reaugmentation. Risks of bottoming out are minimized by limiting implant size and careful surgical dissection in the breast... more

Bottoming out and larger implants?

Usually with bottoming out repairs, smaller implants are a better option. Going larger may push on the repair.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Implant bottoming out repairs need to be carefully done

I think the state-of-the-art operating for bottomed out implants would include reconstructing the infra-mammary fold with Strattice ADM and using a SMALLER implant. Going larger is at cross-purposes with fixing your disrupted infra-mammary fold. You might consider seeking out a couple of additional opinions from surgeons in your area.

Bottoming out following breast augmentation

Thanks for your question. Adding more weight (larger implants) will only place you at a higher risk of bottoming out further if nothing else is done. The inframammary fold needs to be re-enforced. This can be done in a number of ways from the use of external to internal sutures. You will have to speak to your surgeon to find out what is best for your particular set of circumstances.

Repairing a bottomed out breast and going larger is a bad idea

When you have bottomed out, you are already in a tough situation. There are no absolute guarantees that a fix will last especially if you try to put in a bigger and heavier implant which increases the risk of recurrence. Also, based on your photo it looks like you are already maxed out in terms of the width HP implant you can handle. You need to be realistic here and understand that you can't always get what you want.

Prevent Bottoming Out after Revision Breast Surgery?

Thank you for the question and pictures. Generally speaking, breast implant bottoming out is corrected using internal suture “repair” of the breast implant pockets ( capsulorraphy). It may, or may not, be possible to go “larger” depending on each patient's specific situation. In some cases, there may not be enough room in the breast implant pocket ( especially after the capsulorraphy) to accommodate a larger breast implant volume safely. Make sure that... more

Bottoming out and Repair

In general, the pocket will be made smaller and the implant size should not be increased. The implant should not compromise the repair. Once healing is complete, you may contemplate a larger implant at a later date. Underwire bra should not be worn after breast augmentation with an IMF incision.

Revisionary Surgery Complicated

Thank you for your question and photots. Unfortunately you already have bottoming out with 350 cc implants. Larger implants will only increase the risk of recurrence. You would be better served by a capsulorraphy with the same or a smaller sized implant. Best wishes!

Repair of Bottoming out Breast Implants

Tightening the lower implant capsule perhaps with a material called strattice can help your breast shape. Alternatively, an entirely new pocket for the implant can also help. Smaller implants would reduce your risk for recurrent bottoming out. Good luck!