What are the options to fix an implant that has bottomed out. I'm 3 months post op. (photo)

Doctor Answers 15

Options to correct an implant that has bottomed out

Thank you for your question.  Your left implant does appear to be bottomed out, as it sits lower than your native breast fold on that side.  The correction is surgical.  There are a couple of options. One is for your surgeon to use sutures to secure the pocket in a new position.  The success of this type of correction depends on your own tissues--the thickness of the capsule around the implant.  If that capsule is very thin, the sutures won't hold.  

The other option, which I find more reliable in many cases, is to add ADM (acellular dermal matrix--like Surgimend). ADM is a collagen sheet that acts like an internal bra to support the implant.  Talk to your surgeon about your options.

Best wishes,
Dr. Kavali

Atlanta Plastic Surgeon
4.5 out of 5 stars 42 reviews

Bottoming Out

Thank you for your question.  There are ways to fix an implant that has bottomed out but it requires another surgery.  The most common option is to tighten the bottom of your implant capsule.  Talk with your surgeon about your concerns and further discuss the best option for you.  Good Luck. 

Frederick G. Weniger, MD, FACS, MBA
Hilton Head Island Plastic Surgeon
4.9 out of 5 stars 35 reviews

What are the options to fix a breast implant that has bottomed out. I'm 3 months post op.

Thank you for your question.  I am very sorry to hear of your difficulty.  Your correct at the left breast implant has bottomed out.

This can be revised but will require a revision of the breast implant pocket.  To see what is involved please see the following link:

Bottoming out

The capsule needs to be tightened inferiorly, putting the crease back where it needs to be.
Good luck

Gregory Sexton, MD
Columbia Plastic Surgeon
4.9 out of 5 stars 73 reviews

Bottomed out implant

 Your left breast on the photograph appears bottomed out to me. In my opinion, this is best repaired definitively using acellular dermal matrix such as Strattice to reinforce the new bottom of the pocket.  I have found that sutures only many times will allow for recurrence of the bottomed out appearance. Therefore I look at the extra cost of Strattice as an insurance policy. Find a board-certified plastic surgeon in your region with experience in revision cosmetic breast surgery. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews


Hello, typical ways include reenforcing the bottom of the support tissues with suture alone or a mesh and suture. I would seek out a board certified plastic surgeon who can examine you and go over specifics. Good Luck.

Paul W. Papillion, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 58 reviews

Bottoming out

The way to fix this problem is to re-create the fold under your breast where it was originally.  This can be done using sutures inside the breast pocket.  Sometimes acellular dermal matrix (ADM), such as Surgimend, Alloderm, Flex HD, etc., can be used to strengthen the repair.  This stuff is very expensive, however, so I rarely use it.  I have found that I can get nice results using sutures alone.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 24 reviews

Bottoming out

A surgical closure of the implant pocket along the lower pole would be indicated.  You do not need a lift or any skin excision to correct this.  

John Michael Thomassen, MD
Fort Lauderdale Plastic Surgeon
4.9 out of 5 stars 49 reviews

What are the options

There are many ways to fix an implant that has moved too low. The scar tissue ( capsule) that is too low can be used to move the infra mammary fold to the proper position. Alternately if the capsule is too thin you can use the excess skin from the nipple to the fold and sew this to the chest wall. Adding acellular dermal matrix (ADM) adds strength but cost as well. Another option is changing the pocket. See your surgeon for best advice. Good luck.

Robert Graper, MD
Charlotte Plastic Surgeon
4.4 out of 5 stars 27 reviews


There are several ways to fix your left breast bottoming out.
You can use the capsule of the lower pole to reposition the implant.
If the capsule not strong enough you can reinforce it with acellular dermal matrix.

Deborah Sillins, MD
Cincinnati 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.