Asymmetry and Bottoming out? (photo)

I have considerable asymmetry and also bottoming out of one breast. It is suggested I have a mastopexy and replace the implants from saline to silicone in hopes of correcting the issue. Also using Strattice to help correct the bottoming out issue. My first augmentation was in 2006 and another was completed in 2007 due to continued asymmetry. My goal is to have considerably more symmetry, better cleavage, and a better shape overall. With a full lift is this possible?

Doctor Answers 3

Fixing bottomed out implants can be done with capsule adjustment and breast lift

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There are a couple of pitfalls in the surgery you need that you should be aware of.  

When an implant bottoms out, it is because the implants are too heavy for the tissue to hold in the right position.  It is an indication that the inframammary fold (the fold under your breasts) is not strong enough to support the weight of your implants.  This can be fixed by putting sutures to support the fold and also by placing strattice or alloderm (tissue support material), to create a supportive sling.  But, if the implant is heavy enough and your tissue is weak enough, none of these measures will hold the implant for a long term fix.  

Looking at your photo, the anatomy of your chest wall is such that the distance between the collar bone and inframammary fold is relatively long.  This means, you would need a fairly large implant to create fullness in the upper pole.  The problem is that the implant may be too large and too heavy for your inframammary fold and your breast skin to hold in position.

So, it may not necessarily be possible to have a long term fix to bottoming out without downsizing your implants.

So, please keep these issues in the back of your mind as you proceed.  And best wishes to you.

Newport Beach Plastic Surgeon
5.0 out of 5 stars 28 reviews

Asymmetry and bottoming out

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The short answer is yes, a full lift will be the best option, I would use a vertical mastopexy with a lollipop scar.  Stattice can help correct bottoming out.  Changing from saline to silicone will not address any of your concerns, but will make your breasts feel softer as you don't have much of your own breast tissue.

Leonard T. Yu, MD
Maui Plastic Surgeon

Asymmetry and bottoming out after 2 previous augmentations

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Thank you for the photo.Obviously you arte are well red about how this needs to be corrected for a longer lasting result. You are thin with thin tissues and probably very little breast tissue. I personally favor using Strattice, gel implants and a lift. I assume that your implants are submuscular. See a board certified plastic surgeon for an in person evaluation. Good luck.

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