What are my chances of bottoming out and other complications? (Photo)

Question

Hi i would like multiple opinions on this questions: I'm a petite asian girl. (110 pounds, 5'2, pre op: A cup, bwd is 12.5). Im planning to get 415 cc's which is my max for my bwd. What are my chances of bottoming out, i know noone can give me an exact percentage but i just want to know if its in the 50% range or whichever range. I have attached a before photo of myself so you can have a better idea on how much breast tissue i have)

Donovan Rosas, MD · Answer

Breast augmentation is a safe procedure with a relatively low complication rate.Bottoming out is a complication defined by progressive descent of the implant below the already established fold or crease at the base of the breast where the mound meets the chest wall. The risks of bottoming out are certainly lower than 50%. While it is difficult to give an accurate assessment of risk without an in-person exam and an assessment of anatomy/skin quality, the risk is likely to fall in the single digits (less than 5%). There are a few well known risk factors for bottoming out. These include:-Large or heavy implants (exert greater downward pressure due to gravity)-Disruption of the native fold and associated anatomy-Poor tissue qualityAs always, discuss your concerns with a board certified plastic surgeon.

Aldo Guerra, MD · Answer

You seem to be a good candidate for breast implants and your chances are very high for a successful outcome. A discussion about specific complications, like bottoming out, is something you should do with your plastic surgeon. Your anatomy is favorable for low complications, but risks can increase depending on which implant size you choose. Bigger breast implants bigger risks. Good luck, Dr. Aldo

Nana N. Mizuguchi, MD, FACS · Answer

Your risk for most complications are quite low.  With proper surgery and the appropriate selection of type, size, and profile of the breast implant will further reduce the risk.  You have what appears to be a relatively longer nipple to fold distance.  Depending on how much your fold stretches, you may be a better candidate to use a textured breast implant.Best Wishes,Nana Mizuguchi, MD

Peter J. Capizzi, MD · Answer

lower than 50% and in your case I would say lower than 5%.  What is important is the assessment preop at the consultation, your skin, history of breast size, child bearing, type of implant (smooth vs. textured), and the skill of the surgeon doing the procedure.  I have done over 5000 breast implant procedures and you should have an excellent result.

Andre Aboolian, MD · Answer

Your risk of bottoming out is very little.  Instead of worrying about bottoming out you should worry about the 415cc size; in my opinion that is too big for your frame and it only means you are increaseing your risk of having other surgeries in the future including for correction of bottoming out.  Please see other plastic surgeons in your area, but before you do that make sure to review the before/after photos to see if you like their results (make sure they show you front, quarter turn and profile views for each patient).

Curtis Wong, MD · Answer

you can choose textured anatomic (not round) implants and if they heal as designed, they are not supposed to move at all.  With round implants, if your fold has to be lowered to accommodate your volume, bottoming out is a risk but its still on the slim side.  Bottom line, if you want implants, you have to accept risks.  And surgeon technique is important as well as anchoring the new fold helps prevent bottoming out from happening,  but not all surgeons do this.

Johnson C. Lee, MD · Answer

Thank you for your photos. Bottoming out can occur from having thin and poorly elastic tissue (genetics), inappropriate support wear (environment), or poor technique (human error). If you do not have these issues, then your chances of bottoming out are slim and should nto be higher than the average patient who gets breast augmentation. Hope this helps!Johnson C. Lee, MD Plastic Surgery

Marisa Lawrence, MD · Answer

Bottoming out occurs when there is thinned skin and the chest wall muscle is detached inferiorly.  If the implant is placed properly and your tissues are healthy and not thinned and stretched, your chances of bottoming out are small.  The fact that your surgeon gave you a "Max Size" is a good sign - it is important for the surgeon to respect the tissue characteristics of the patient.  Follow you surgeon's post-operative instructions carefully for the best result.  Good luck with your surgery.

Mehdi K. Mazaheri, MD · Answer

Thank you for your question and the photos. It's very difficult to give you the chances of bottoming out. My guess would be less than 5%. I do feel that the 415 mL implant that you've chosen is too big for you. I think a HP 350-375 would fit your body better. Good luck. DrMaz

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Based on your anatomic starting point, you should have a very nice outcome with breast augmentation surgery. However, you are wise in inquiring about the risk of complications again.  You will find a lot of information on this website, and on the attached link, regarding the variety of potential risks/complications associated with breast augmentation surgery. The specific risk of bottoming out should be very low (less than 1-2% would be my best estimation). The most important decision you make when it comes to avoidance of complications is careful selection of plastic surgeon. When this decision is made, variables such as good judgment and skillful execution of the procedure will follow.

Some factors that may increase risk of "bottoming out" include the need to "lower" the inframammary fold (disruption of the patient's natural supportive anatomy); this dissection (or over dissection) may predispose a patient to  breast implant displacement complications.  Utilization of a breast implant that is too large for a patient's frame may also be problematic.

"Genetic" factors (patient tissue concerns), in my opinion, play a very small role when it comes to potential problems with breast displacement.

Your best bet: choose your plastic surgeon very carefully; everything else including good judgment/advice/planning, anesthesia provider and safe surgery facility will follow.  Always keep priorities (safety,  avoidance of complications, and quality of outcome) in mind as you make your decisions.  Best wishes.

What are my chances of bottoming out and other complications? (Photo)

Answers (12)

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