Bottoming out or just old IMF crease? (Photo)

Question

Am i bottoming out? Or is this just my original crease that will even out? Im 6 months post op.

Jonathan Heistein, MD · Answer

Hi.  It looks like the implant is pushing below your normal crease on that side.  You should show your surgeon so he/she can help you decide how to proceed, and also follow along with your progression.  Best of luck!

Donovan Rosas, MD · Answer

Bottoming out occurs when an implant migrates below the native fold. This can occur if the anatomic structures are disrupted during augmentation or if an oversized implant attenuates the support over time.

Based on your photos, there may be an element of bottoming out at play but this is difficult to say for certain without an in-person exam.

That being said, revision is an option and may involve reinforcing the fold, +/- mesh placement, +/- implant change/downsize.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ira H. Rex III, MD · Answer

I cannot answer your question without a preoperative exam and knowing your surgeons plan for  inframammary fold position.  If you have any concerns, it would probably be a good idea to see your plastic surgeon.  Overall it seems you have a nice result and if this stays stable.

Daniel Barrett, MD · Answer

Dear cammie3690,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Raja Mohan, MD · Answer

It is hard to say for sure but looks like bottoming out. Recommend seeing your original surgeon for an examination.

Camille Cash, MD · Answer

From the submitted photos it does appear you are bottoming out.  This can be corrected by tightening the lower portion of the pocket.  Reducing the implant size may help as well.  Sometimes mesh is recommended to provide more support to the tissues.  I've included a video I hope you find helpful.

Connie Hiers, MD, FACS · Answer

You are bottoming out some. I do suggest wearing a good supporting bra with underwire support. If this bothers you, your inferior pocket could be tightened. You may need to go down in size.

Bottoming out or just old IMF crease? (Photo)

Answers (7)

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