I would like to know if I am bottoming out and if so, if its worth fixing? (photo)

I would like to know if I am bottoming out. I've realized my nipples are very close to popping out of bras and swimsuits. I was told that the implant at the bottom is normal, and that my breast tissue that is visible will diminish over time. My left breast was larger pre surgery. I got 375CC, medium profile, silicone, under the muscle. My surgery was 6months and two weeks ago. I would like to know if its even worth fixing. I just don't want my implant dropping too low over time.

Doctor Answers 11

Implant bottoming out over time

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Thank you very much for your question and photographs.
Based on your photographs, it appears that your implant has descended and has become a bit too lateral as well (also known as bottoming out). The decision to undergo revision is yours to make. Your implants may drop more, and no one can predict this (or not). I believe you would benefit from revisionary surgery, by either placing sutures to lift the capsule (capsulorraphy) or by placing an internal support system (mesh versus dermal matrix), or a combination of both. Seek a board certified plastic surgeon to help you achieve the look you deserve. Best of luck to you...

Implants bottoming out?

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Hi Hillary27
I am not sure if I would call it bottoming out, as I think of bottoming out as a process over time where the implants descend to a point lower than intended, with resultant consequences.
I do see that the implants are lower than ideal, and so I guess one could say that they have bottomed out.  Although this is obvious on front view, the quarter views demonstrate the bottoming out most (IMHO).
I think that correcting the malpositioned implants will not only give you a greatly improved aesthetic result, it will also take care of the problems you have identified.
I don't believe that the "fix" should be that hard and the recovery should not be bad.  I would hasten to add that malpositioned implants does occur from time to time.  If you have trust in your surgeon, he should be the one to address the issue.
Finally, the issue of if it is "worth it" is totally subjective and only you can answer that.  For me, I would, and I would not wait too long to do it.  Not an emergency, but better to get it over and done with, or, accept the way it is.
All the best.

Bottoming Out

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Thanks for your question! Based on your photos, it does appear that you are in fact bottoming out a little; however, the decision to revise this is up to you. I've certainly seen worse in my largely cosmetic breast practice. I would bring the concern up to your plastic surgeon. You may need a capsulorrhaphy and capsulotomy in the future to move the implants more up & in; however, I think that your volume looks good. Best of luck!

Robert P. Schmid, MD
Lubbock Plastic Surgeon
4.8 out of 5 stars 41 reviews

I would like to know if I am bottoming out after breast augmentation?

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I am sorry to hear about/see the problem you are having after breast augmentation surgery. I think your concerns are appropriate; your breast implant does seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”). It is possible that you are feeling the implants significantly along the lower poles of the breasts. Also, consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low. 
I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation. 
In my practice, this type of repair involves a two layer, permanent suture repair (reconstructing the inframammary fold areas). Sometimes, depending on the clinical situation and history, the use of additional support materials such as acellular dermal matrix or biosynthetic mesh is also helpful. The good news: with a well executed procedure, an outcome close to your goal photographs is achievable.    Make sure that the plastic surgeon who does this procedure for you can demonstrate significant experience with this type of revisionary breast surgery.  Key will be:  your surgeon's experience level, careful execution of the procedure, careful attention to postoperative care/activity restrictions. I hope this, and the attached link (dedicated to corrective surgery for bottoming out concerns), helps.

Bottoming Out after Breast Augmentation #breastaugmentation #breastimplants

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  • Your implants have bottomed out on both sides.
  • They may not migrate much lower over time.
  • The decision to undergo revisional breast surgery is yours to make, of course. 
  • Another operation would be required, and internal sutures would be placed to help raise the fold beneath your breasts. 
  • Thanks for sharing, and sorry to hear that this has happened to you. 

Breast Implants Bottoming Out

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Breast implants put force and stretch on the lower aspect of the breast. Over time, in some patients, breast implants descend too much where they are not centered on the nipple and on the chest. This will not improve over time and likely can worsen. Correction is related to the integrity of the infra-mammary fold and may entail raising the fold, reinforcing the fold, choosing narrower implants and lower pole skin excision....or all of the above. 

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 52 reviews

Is "bottoming out" worth fixing?

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That's a good question, but it is one that only you can answer. It does appear that you have bottomed out a bit and correction can be achieved with a revision surgery. 

Robert N. Young, MD, FACS
San Antonio Plastic Surgeon
4.6 out of 5 stars 73 reviews

Is my implants bottom out

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Thank you for your question. Looks like they did bottom out. whether they are going to get worse or not it is difficult to predict. It may not get worse anymore. Fixing them completely depending on your choice. Please talk to your PS for evaluation and to discuss the options.

Bottoming out? And if so, if its worth fixing?

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Both creases are a little low relative to the position of your nipple, however the creases could be rather easily changed and you could achieve improvement in the implant position, which should help with your clothing issues. 
In determining whether it's worth fixing, that's probably a a personal choice and one only you can make. 

You have bottomed out

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You have already bottomed out.  It can be fixed. However choice of having surgery or not is entirely up to you.  

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 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.