Bottomed out with 375 Salines Would Going 100cc's Larger Make a Diiference And More Revisions if Im Diagnosed with Thin Skin?

Small B Placed 375/380cc Mod+ Salines & couple months was diagnosed with Bottoming out of both implants, was told to come for a revision along with switching to a 450/475 Silicone implants in mind. im currently 100lbs 5'3 with about 27in ribcage id say im like mary kate&ashleys frame but less tall. will goin up 100ccs be a good idea to place when i fix the bottom out? On small frame w/ thin skin would size be a big difference or problems? This is stressful but im happy to get as much help :)

Doctor Answers 22

Bottomed out Breasts will NOT benefit from going larger

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Hi there-

The fundamental problem, which is a poorly dissected implant pocket, will remain, but will now be further complicated by a larger and heavier implant.

This may look better initially, but is doomed to fail over the longer term.

Your best bet is to correct the fundamental problem- the implant pocket itself.

Saline implants bottomed out

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As a rule saline implants are heavier and have more of a tendency to bottom out than gel implants. Having said that I would not advise changing to even larger gel implants. This will only aggrevate the situation. An inferior capsulorraphy may be helpful. If, at the same time, you would like to change to gel implants  consider going to a smaller volume than you currently have. This better increases your chance of having a long term satisfactory result.

Ann F. Reilley, MD (retired)
Baton Rouge Plastic Surgeon

Breast Implant Revision - Bottomed out with 375 Salines Would Going 100cc's Larger Make a Difference?

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It's difficult to say without photos or an in-person examination but I would be concerned that going 100 cc larger would make the situation WORSE.  You first have to try figure out why you have bottoming out - it may be a question of how the pocket was made, what you looked like before, what your tissue is like, or any combination of those and other factors.  Repairing the anatomy may not be that simple but may include the addition of an Acellular Dermal Matrix (ADM) to help support the lower portion of the pocket.  You could also consider switching to textured implants to help "hold" the position but that may not be adequate and, if you do have thinner skin, then that may not be advisable.  In short, you may need more than just switching implants, and going larger may bot be a good idea.

I hope that this helps, and good luck,

Dr. E

Will Larger Implants Fix Bottoming Out?

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Your "bottoming out' is quite likely due to thinning of your tissues by the weight of your implant. A larger implant is likely to trigger a cascade of implant problems. Get a second opinion from an experienced surgeon certified by the American Board of Plastic Surgery. There must be a better solution for you.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 117 reviews

Correction of bottoming out

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At this point, I would worry much less about changing the size of the implants and be concerned more about the loss of support to the current implants.  There are several ways to correct this, but this usually involves more than simply tightening the capsule around the implant.  Therefore I would be suspicious of any surgeon recommending a simply change in the size of the implant or a minor revision of the capsule.  

Tito Vasquez, MD, FACS
Southport Plastic Surgeon
4.7 out of 5 stars 17 reviews

Thin skin & tissue stretch

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Think of a ball inside a sock.  A lighter ball isn't going to stretch out the sock as much as a heavier ball would.

If your skin is thin and stretchy, you want to avoid things that would make it more prone to fail.  Don't go to a larger size - if anything, you may want to downsize to a smaller & lighter implant.

Consider repairing the pocket with sutures or reinforcing the skin with Strattice.  Expensive, but it works.



All the best,

The bigger they are...

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You know how the saying goes.  Putting in larger (i.e. heavier) implants will only worsen your bottoming out and tissue thinning.  The "revision" might help the bottoming out, depending on what the plan of the "revision" is, but larger implants are likely to compromise that as well.  Be sure that you are in the hands of a plastic surgeon certified by the American Board of Plastic Surgery before proceeding.  Good luck!

Exchange of implant for bottoming out

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If you have bottomed out with 375 cc implants, switching to a larger implant will worsen the situation. SIgnificantly, you haven't mentioned whether the implants were above or below the muscle.

Breast Implant Revision?

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Thank you for the question.

It is not possible to give you precise advice without direct examination.

Based on your description of body type and the size of the implants are contemplating you are at risk for further complications. Correction of the “bottoming out” will likely require permanent suture repair (capsulorraphy)  and/or the use of allograft. Use of a larger implant will stress this repair.

I would suggest consultation with well experienced board-certified plastic surgeons with significant experience doing revisionary breast surgery.

I hope this helps.

Bottoming out

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Bottoming out many times means that your tissue could not handle the size of your implants. Going larger may make it worse.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.