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What can be done to prevent bottoming out of breast implants? Well first and foremost, the surgeon should use breast implants that are of an appropriate size and shape for a patient's starting point. Overly-large implants frequently, over time, will stretch out the skin and the soft tissue of the lower pole, allowing the implants to descend and create that bottomed-out appearance.

Some patients need to have their inframammary fold lowered in order to achieve an aesthetically ideal implant position. And that is another setting that creates some risk of, over time, a bottomed-out appearance. There are things that can be done, however, in the setting of intentional lowering of the inframammary fold, to prevent that outcome.

One important thing to do is to use an inframammary fold incision. And at the end of the procedure, after the implants are placed, an anchoring suture can be placed to secure the deep connective tissue of the skin to the connective tissue of the chest wall. This creates at least a temporary barrier as the implant is healing, reducing the likelihood of the implant settling over time.

Another important thing to consider is implant selection when you're lowering the inframammary fold. Currently, implants are available with a high degree of capsular adherence to the implant surface. If the capsule that your body forms around the implant becomes adherent to the implant surface, then this will help it to remain positionally stable over time.

What Can Be Done to Prevent Bottoming Out?

Dr. Michael Law explains what can be done during breast augmentation surgery to prevent bottoming out, or an implant that slips too low in the envelope.

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