Bottomed out implant 7 years post op. Spoke to a surgeon that wants to use mesh. Thoughts? (photos)

Question

Hi, I had a breast augmentation 7 years ago. Silicone 250cc implants under the muscle. Recently I've noticed one has dropped a significant amount lower. I had a scan to confirm that the implant is not ruptured. Is this a common for this to happen with implants and what is the cause? I spoke to a surgeon who wants to use mesh and just wondering what other surgeons thoughts are on this? I have attached a pic of what they look like now and what they looked like when I first had them done.

John LoMonaco, MD, FACS · Answer

First and foremost you need a good examination (and I would do a quick in-office ultrasound) to diagnose the exact issue.  I am seeing the areola on the left a bit larger and the entire breast a bit fuller than on the right, and of course the breast fold is much lower.  Fluid collection, rupture, and other problems need to be excluded before proceeding with any surgery.

In the case of a "bottomed out" or dropped implant, I do often use an absorbable mesh to reinforce the tissues along with repair of the capsule.

Most important is to try and figure out "why" it happened (i.e. an implant that is too large to be supported by your tissues, etc) and not repeat the error.

Jonathan Heistein, MD · Answer

Hi.  What you have is called "bottoming out," and it occurs when there isn't enough support to prevent the implant from lowering.  It can be fixed with stitches, or mesh (Galaflex), or both.  Make sure you go to a surgeon who is experienced with fixing these problems, since there are a few nuances to the surgery that need to be done to get it right.  Best of luck!

John Michael Thomassen, MD · Answer

If the inframammary fold attachments were violated there is a risk of implant descent.  With large implants this may be a fait accomplit as the size of the implants forces the issue.  In your case, the implants are not that large so a revision to repair the inframammary fold, with or without mesh, should work.

Connie Hiers, MD, FACS · Answer

Using mesh would probably work well for you. I suspect you do not have much breast tissue and the implant was not being supported. Do not go bigger.

Bottomed out implant 7 years post op. Spoke to a surgeon that wants to use mesh. Thoughts? (photos)

Answers (4)

Answer: Surgery

Answer: Surgery

Recommended reading

Everything you need to know about Breast Implant Revision

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Bottomed out implant 7 years post op. Spoke to a surgeon that wants to use mesh. Thoughts? (photos)

Answers (4)

Answer: Surgery

Answer: Surgery

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.