BA + BL almost a year ago, got 350cc's HP gummy bear implants. Bottomed Out? (photos)

At size 34, each 100 cc of implant corresponds to 1 cup size change. All you needed was 100-200 cc implants to take you to a D or DD. At this time, your implants are too big and too heavy and that is why they have bottomed out. I recommend removing the large implants, replace with smaller ones and revise the breast lift. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, the implants can be exchanged for smaller ones.

Best Wishes,

Gary Horndeski, M.D.

Your photos suggest your appearance could be improved by adjusting the position of your implants. Options to achieve this can be discussed with your surgeon. Start by revisiting your concerns and expressing your dissatisfaction.

You have too
Much skin in the lower portion of your breast. You need to have the lollipop lift converted to a full anchor lift to remove the excess skin.

It looks like you may want a revision of your mastopexy to decrease the distance from your nipple to your fold.
Good luck

Greg Sexton MD

Dear Lcp0484,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I am not a fan of the gummy implants. You would do better with smooth round implants placed behind the muscle for better upper breast fullness. Your pockets will also need to be tightened, and you might need to go somewhat smaller so the weight does not sag again.

As many as 20% of patients having breast augmentation with mastopexy will require a revisional mastopexy within the first two years after surgery. You look very fit and muscular and if you are exercising your pectoralis muscles regularly, you are promoting the bottoming out by the muscle action on the implant pushing it down and out from underneath the muscle. You may benefit from replacement of the implant above the muscle even though you risk seeing some rippling through your very thin skin. There are some new implants with slightly thicker ("gummier") gel that can minimize the wrinkling. Mesh (either biologic or biosynthetic) may be an option to help prevent recurrent ptosis but I don't think you are going to be happy unless you seek revisional surgery.

The photos show too much tissue at the bottom of the breast. A revision of your lift is needed to correct this. If your surgeon is not responsive to your concerns I encourage you to visit with a different board certified plastic surgeon.

Your case is exactly why I use mesh in almost 100% of my mastopexy aug patients. Your skin alone can’t support the implant. I would redo your lift and add Galaflex for support. I have women in their 70’s now with breasts looking like they are in their 20’s. If you are happy with the size you don’t need to replace the implants.

Without in person or even virtual examination very hard to be sure you are bottomed? Might offer re lifting using full anchor lift techniques.