Is This Bottom Out? Is a Revision Surgery Worth of Doing? (photo)

I did my breast augmentation in April, 2012. In September 2012, I had to do a small revision surgery to cut my bad scar on my right breast. Then three weeks ago (late May 2013), I noticed that the same breast is much lower than the other. I originally put in the 225 cc silicon implant. I have a very small frame (5'2').Could anyone please tell me if a revision surgery is necessary? When the first surgery is going on, I feel tremendous pain on my right breast even with the anesthesia, is this relevant?

Doctor Answers 8

Maybe a little...

I think just a bit...but not bad. You were full in the lower pole of the breast before surgery and you still are but the correction is not an easy one so only consider it if it REALLY bugs you...But you look to be in a normal range...

Phoenix Plastic Surgeon
4.6 out of 5 stars 45 reviews

Is This Bottom Out? Is a Revision Surgery Worth of Doing?

Poorly posted photos! But it seems to be very minor bottoming but if you are concerned than ONLY reoperation can attempt to correct. There would be additional expenses and if using a ACDM the costs double. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Bottoming out

You may have mild bottoming out, but hard to say without an exam. If it is minor you m ay not want to do anything about it.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Is This Bottom Out? Is a Revision Surgery Worth of Doing?

The essential part of both photos is rather dark and hard to make out. It does look like some bottoming out on the right. This will not get better without surgery, so the decision is based on how much the problem bothers you.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

To correct bottoming out.

You do have a small degree of bottoming out.  The question of whether or not to surgically revise your breasts depends  upon how much this bothers you.  the correction would be an inferior capsuleopexy to raise the implant so that the center of the implant is behind the center of the nipple.  At this point your nipples are starting to point up.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Bottoming out may or may not be worthy of an operation.

Modest bottoming out may be better left alone. Sub pectoral implants seem to be more prone because of the vector of force generated by action of the pectoralis muscle. Moving the implants from sub muscular to sub glandular can help.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Is This Bottom Out? Is a Revision Surgery Worth of Doing?

Dear Superconcern,

Thank you for your question and photos.  Yes, you do have bottoming out in both breasts, with the right being more so than the left.  Your nipples are in the upper half of both breasts, and should be in the lower half.  The right side is more accentuated than the left.  To revise this, the pocket needs to be excised and sown shut and reinforced with a dermal matrix for most permanent results.  I would also suggest using a textured implant instead of smooth, as the body grows into the pores of the texture and helps hold it in place, long term.  I suggest following up with a board certifed plastic surgeon for this surgery.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 48 reviews

Revision surgery for bottoming out

Based on your photos, it is clear that the right breast is somewhat lower than the left.  Whether revision surgery is worth it depends on how unhappy you are with the appearance of your breasts. Surgery can elevate the position of the inframammary fold on the right to improve symmetry with the left side. If this is your goal, then I think it would be worth it. With regard to the pain during your first surgery, I can't tell you if this was related to your current condition. Thank you for sharing your photos and concerns. Best wishes.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

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