Why does my right boob keep bottoming out? Should I take the implants out & do fat transfer? (Photos)

There is some confusion about what an internal bra is, so it is important to know what you have had done in order to make a recommendation. I define an internal bra as the addition of a layer of support with a material such as Galaflex mesh or ADM such as Strattice. It is not simply suturing the capsule, which is correctly called a capsulorrhaphy. The confusion arises because some surgeons call a capsulorrhaphy an internal bra if they use permanent sutures, but that doesn't add the type of support you need. I doubt you would be happy with explantation and fat grafting.

You might benefit from downsizing the implant to a smaller volume but more implant height (a lower profile smaller implant). You may just have too large of implants for the soft tissue support that you currently have. Large implants can continue to create stretch deformities of the nipple-to-fold distance and/or "bottom out" the inframammary fold due to force of gravity/stretch over time. I would truly see an expert in breast revision surgery in order to ensure that you get a very comprehensive plan.

One of your implants is sliding down what creates visible asymmetry; it happens more frequently with large implants like in your case. Lifting and fixing inframammary fold on that side would create symmetry and prevent further displacement, migration of the implant. You may also consider smaller imlants? In person consultation with a board certified plastic surgeon is recommended. Good luck.