Currently 375 Mod+ Saline Wanna Switch to 500 HP Silicone, Do I Run Risk of Bottoming Out?

I have 375cc mod+ put me at a small D cup! i started with a small B & a 3" gap in between clevage area i figured the bigger the size the gap & breast would come together so i figure going 475cc & up would help? Also couple months after Aug i went to my post-op and doctor told me im bottoming out&will have stitches placed beneath to fix them So considering to go larger as well will the lift help bigger implants to stay up on smaller frames or bottom out again? Is implant weight the cause?

Doctor Answers 12

Bottoming out

Your surgeon has the answer for the bottoming out part.  To help the cleavage by moving the implants more medial can be done with more dissection medially.  To still keep the implant centerd behind the nipple may require an implant with a wider diameter.  This can be done with either a bigger implant or lower profile.

Mobile Plastic Surgeon
4.6 out of 5 stars 23 reviews

Increased Risk of Bottoming Out?

 Thank you for the question.

It is not possible to give you precise advice without direct examination.

Based on your description of body type and the size of the implants are contemplating you are at risk for further complications. Correction of the “bottoming out” will likely require permanent suture repair (capsulorraphy)  and/or the use of allograft. Use of a larger implant will stress this repair.

I would suggest consultation with well experienced board-certified plastic surgeons with significant experience doing revisionary breast surgery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Gap Between Breasts

A common misconception is that if you get larger implants the space between the breasts will be narrowed and better cleavage will be achieved.  Unfortunately, for the most part, this isn't true.  The medial boarder of the breast or the edge of the breast closest to the breast bone is anatomically defined.  This means that the tissues are structurally attached to the chest wall at their specific location.  For some women the breasts are very close together.  For other women they can be an inch or more apart.  Regardless, violation of this boarder during surgery can easily result is the loss of definition between the breasts or monobreast.

Bottoming out is usually the result of poor tissue and not necessary the implants themselves.  If the surgery to done correctly and the deep tissues are reapproximated appropriately patients will achieve a great result.  However, even when done well some patients have poor tissue and bottoming out can result.  To correct this stitches are placed between the skin and the chest wall to lift the inframammary fold.  Larger implants would not be appropriate as the added weight could accelerate the bottoming out process.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

Larger implant will exacerbate bottoming out

True bottoming out is usually caused by stretching of the lower pole skin.  A larger implant will exacerbate this.  It is also possible that the inframammary fold attachments have been disrupted and there is a fold malposition.  If this needs to be repaired, a larger implant can adversely affect the repair.  in my opinion high profile stretch the tissues more than lower profile implants and will exacerbate all of these issues.   Please remember to send us photos.  Hope this helps.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 27 reviews

Large implants can cause bottoming out

Improper inferior dissection causes 'bottoming out'. Heavy implants expidite this. Trying to increase cleavage by replacing implants with larger size will not work. Larger implants will only make things worse in the long run by stretching your tissue out; making correction more difficult.  Your PS will need to plicate laterally as well as inferiorly to make the pocket smaller so that implants are pushed medially (towards center). I've achieved this successfully with women in your situation. Consult a Board Certified Plastic surgeon with experience in correcting such a problem. Best wishes, Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Implants and bottoming out

If you have issues with bottomong out, going larger is not necessarily a good thing. In fact, you  may want to place smaller ( lighter) implants in after the fold is fixed.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast Implant Size

Without seeing you in person or examining you or photos, it is very difficult to give you specific advice.  So, you should seek a consultation from a board certified plastic surgeon.  The size of implant that you can accomodate really depends on your anatomy, your skin thickness and your expectations of look and feel (fake versus natural).  In our office we can perform imaging and show you approximations of what your final result will look like back on specific implant sizes.  


Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Technical Details of your Options Requires an Exam

Hi there-

It would be impossible to makd detailed recommendations for the management of your situation without knowing you and your goals better and performing a detailed in-person examination of your breasts.

Please visit a surgeon Certified by The American Board of Plastic Surgery with a lot of experience in Breast Surgery.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Currently 375 Mod+ Saline Wanna Switch to 500 HP Silicone, Do I Run Risk of Bottoming Out?

Very difficult to gibve accurate advise over the internet. Best to obtain a few opinions from boarded PSs in NJ. I think your doc has a good idea. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Implant size

Choosing mplant size is a battle between doing what you want and doing what is safe. The rule I have is use the smallest implant that will make you happy and start with the implant size and dimension that fits your breast. Even without examining you, I can suggest that starting with a small B, the 375 cc. implant is already bigger than fits your natural breast so going larger will incur more problems in the future.

Robin T.W. Yuan, M.D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

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.