I am 5'2" 118# 26 yo. I had a BA w 300cc silicone high profile style 20 implants. This was done dec 11 2012. I began noticing differences in implant position early on. My right was more lateral than my left. My ps now tells me I am bottoming out. Should I see if it gets worse before having it fixed and should I be getting more than $200 off on the price to reop?
Is This Bottoming out Within 3 Months of BA? (photo)
Doctor Answers 10
Breast Implant Malposition With High Profile Implants
I am in agreement with Dr. Tholen with regards to his assessment. You have a form of dropout, although it is more medial (inner) than lower. Additionally ,there is some persistent muscular insertions on the inside of the other breast that could be released. In other words, too much on one side, not enough on the other.
I would like to emphasize a point Dr. Tholen made, for those women who will be reading your post and our responses, for their edification regarding implant choices. You are a classic example of someone with small, tight breasts who received a (relatively) large, high profile implant, and is having complications that will need a revision surgery. Thanks to your very helpful serial photography, you can see where the preoperative issues might occur, and where the post operative problems did occur - 'hindsight is 20/20.' However, given your body anatomy, you were never a good candidate for a high profile implant, and a smaller, intermediate profile implant would have been less likely to cause this unpredictable tissue stretch and subsequent implant malposition.
You are not a unique case, and every day women are getting high profile implants who would be better served with intermediate profile implants of the same diameter, so that the surgeon can 'stuff' more volume in. As you can see, more volume that is stacked on itself (high profile) is just as problematic as more volume spread over a wider area (mod/mod plus profile).
I am sorry you will need another surgery. However, I am sure you will eventually get a beautiful result.
Best of luck!
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Thank you for your photos. You do not have "bottoming out". In your preop photo your left breast is a bit fuller and has a slightly more laterally positioned nipple than the left. Additionally your right breast seems a bit narrower than the left. Implant placement makes your breast larger this magnifies your preop asymmetry. There also could be some differences in the pocket size but only your PS can truly tell you if that is the case.
Pre-existing asymmetries in breast augmentation surgery
You have a fair degree of asymmetry of breast shape and size. Your left breast is smaller and the nipple is lateral to the meridian of the breast. I do not feel that this is bottoming out rather it is about the expected result considering your pre-existing asymmetries.
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Bottomin out ? not ?
I don't really think so...but I can't tell without seeing you in person and better photographs....what I really think is you have had an augmentation that augmented your asymmetry... your left nipple areola complex was lateral to midline before surgery and it's augmented after surgery..... an attempt to medially position your nipple areola could be done but at the cost of scarring, risk of implant exposure and loss, and the need for multiple procedures....again ...you may have bottoming out but that is not what I can see with what I have been given. I hope this helps. Regards, Dr. Weiss
Is This Bottoming out Within 3 Months of BA?
I find myself looking at a nice result. There is some asymmetry, but less than before surgery. The right breast, nipple and areola are more lateral in the before photos, and still are but less so.
The photo on the right has the best chance of showing bottoming out but the area in question is too dark to see. I really see no suggestion of bottoming out, and I would be reluctant to recommend further surgery.
All the best.
Bottoming out three months after augmentation
We can't tell from your photo about bottoming out, though it usually is an issue of implant postioning at just three months and not a gradual bottoming out. Your photo does show an asymmetric skin envelope, and some of the same tendencies after your implants. At this point your breast is not really so bad, and revision is something that should have very sound planning and acheivable goals. You might want to relax and see how your result sorts out after a year or so and then think about what you don't like and what to do about it.
Is this bottoming out?
It is hard to tell from the shadowy photos. Bottoming out means an abnormal lowering of a breast implant to a position lower than desired. If your surgeon thinks it is, it probably is.
You have a very wide chest bone and, as a result, a very wide cleavage. It looks like your plastic surgeon tried to give you more cleavage, however, only bad things can happen when this is done: 1. There is not much over the chest bone other than a thin layer of skin. When this skin is undermined, there is a greater chance for seeing/feeling ripples in the implants. 2. The implants are placed too far medially (towards the chest bone) and not centered under the areola as they should be. This results in nipples that point to opposite walls like yours do. This can be corrected using stitches inside the breast implant pocket to re-build the cleavage area back to its original position. I might also open up the pocket more laterally (towards the armpit) so that the implants are more centered behind your breast tissue and areolae. Breast implants are designed simply to add volume to the breast and should not change the basic shape of the breast. With that in mind, I don't mess with the cleavage area when I do breast augmentations. I tell my patients that implants will give you more volume but push-up/push-in type bras will give you more cleavage.
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.