3 Guidelines to Avoid Bottoming Out of Breast Implants


Bottoming out of breast implants happen when the prostheses fall below the inframammary crease, leading to the sagging appearance or excessive fullness in the lower poles. However, skilled plastic surgeons know the three basic guidelines that can help them prevent or at least minimize such risk.

Take note that the best way to achieve good results from breast augmentation is to choose your surgeon based on his certifications and qualifications. The rule of thumb is to make sure that he is certified by The American Board of Plastic Surgery and is regularly performing breast implant surgery.

1. Proper breast implant size. The general rule of thumb is to use implants whose width, projection, and overall volume will match the patient’s anatomy. Failure to comply with this basic rule can spell trouble—i.e., implant displacement, palpability, skin rippling, and wavering around the edges of implants.

Aside from the breast and chest measurement, the “right” implant size is also determined by the amount of preoperative breast tissue, body frame, lifestyle (i.e., physically active women should choose a more conservative volume), and desired goals.

2. Correct dissection. The pocket where the implants will be placed should not be too big, which could increase the risk of shifting. Over-aggressive dissection could also affect the structural integrity of the breasts, leading to a wide range of cosmetic problems.

Ideally, the implants are centered directly behind the areola complex to simulate the youthful, natural contour of the breast.

3. Create a strong support. Some patients are innately prone to bottoming out and other forms implant displacement because they have very lax tissues or weak ligaments. To minimize such risk, they may need breast lift, internal mesh, and/or tissue substitute such as Strattice or Alloderm.

Article by
Beverly Hills Plastic Surgeon