How can I prevent bottoming out?

Bottoming out is
common when the inframammary fold is released and not firmly sealed and
reinforced.

A weak
inframammary fold will result in downward breast implant displacement once the
breast implant slips below the natural or surgically lowered inframammary
crease overtime.

Clinical signs:

·        
Bottomed out implants end up too low on the chest
wall with the inframammary scars travelling up onto the breast skin.

·        
The nipples will not only point upward, but also
be positioned higher on the breast mounds.

·        
There will be no pain, but you may notice thinning
of the skin at the bottom of the breast, which will allow you to more easily
feel the breast implant.

It is good to be
wearing supportive bras as this prevent further bottoming out. Supportive bras
will apply upward pressure to the fold at the bottom of the breast.

To correct “bottomed out” breasts, a surgeon would need to secure the
implant in an elevated position and then reinforce the implant capsule at the
bottom of the breast with a suture technique. There may be a need for Acellular
Dermal Matrix, a soft-tissue graft, in the repair. A smaller implant is often
advisable, if the original was too large. In fact, receiving an implant larger
than indicated by your breast characteristics and boundaries increases the risk
of malposition. 

True prevention of bottoming out requires choosing implants that are
tailored to your breast anatomy and characteristics.

Your surgeon may use tissue-based planning to determine the implant
size. The planning takes into account the effects of implants on tissues over
time, risks of excessive stretch, excessive thinning, visible or palpable
implant edges, visible traction rippling, ptosis (sagging), and breast
tissue wasting.  

To determine the final implant size, breast measurements such as breast
base width, breast skin stretch, and nipple-to-inframammary fold distance. The
combination of these measurements will help determined tissue coverage and the
required implant volume to optimally fill the breasts.

Please have an in-person consultation with a board-certified plastic
surgeon and share all your concerns, desires, motivations for the breast
augmentation surgery.

Hope this helps.

Bottoming out, which is also called pseudoptosis, is an unfortunate complication we occasionally see with breast implant surgery.  It is secondary to the lower breast fold releasing and the implant then rests in an unnatural low position.  It is either from poor quality of lower breast and muscle tissue, poor formation of the breast capsule, or over dissecton of the lower fold which allows the implant to drop too low.  We quite often see it from implant patients who perform a lot of heavy chest exercises or movements such as burpees.  It can be fixed with tightening the lower capsule but sometimes requires mesh placement for additonnal strength.

 

From what you have described it is unlikely for you to bottom out given the implant sizes.  Quite frequently, bottoming out is seen when too large of an implant is placed and/or the inframammary tuck is disturbed.  Bottoming out can also be seen in patients with weaker and thinner tissues (genetics).  It is also believed that higher profile implants pose a greater risk of bottoming out and excessive lower pole stretch as they exert greater force on the tissues.This is why is very important to choose your surgeon carefully, you want him/her to be cautious and to provide you with a procedure that will last you and your body a long time free of complications.Hope that helps.