Am I Bottomed Out? Still Saggy and Flat a Year Later! (photo)

I had breast lift and breast augmentation march 2011 I am very unhappy with my results but don't have money for revision surgery. I have 480cc in each breast but I don't think my doctor took enough of my own tissue out because I still look saggy and flat on top of my chest and I can feel my implant going under my armpits pretty much. What do you think?

Doctor Answers 9

Bottoming out after Mastopexy-Aug

I don't think you have "bottomed out". Bottoming out happens when the implant falls below the breast. Your situations looks like the breast tissue is still below the implant. I am a little surprised that your implants are 480cc  as I would have expected much more fullness through out the breast. either your implants have shifted to the outside, like what you suspect, or the implants may be a lower profile. Only your surgeon will know for sure.

Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Breast augmentation and breast lift question

Thank you for the helpful pictures they give me some information to try to help.I  really need a better medical history of your breasts and body. You may have had prior weight loss surgery or multiple prior children. It appears to me that you have extra skin and breast tissue. You do not appear to have bottomed out from what I can see.  If the implants are too far under your arms when you lie on your back the pockets may be too wide.

In patients with lots of extra skin and breast tissue I generally stage the breast surgeries which means the first procedure is to lift and reduce the skin and breast tissue to a much smaller size. The second procedure done 4 to 6 months later is an augmentation and some times another small lift  is needed . It is amazing at how the skin  in some patients can relax after the first procedure. I hope this helps, your plastic surgeon should be able to give you options which may include another lift and closing off some of the internal pocket.

Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Mini Ultimate Breast Lift for bottoming out breasts

From your photographs, it appears you had a breast augmentatin done with a lollipop incision.  Unfortunately, this technique does not provide upper pole fullness and your implants have descended.  You will need a revision with smaller implants placed retro-pectoral and the breast tissue elevated higher on the chest wall.  You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  The only scar would be around the areola.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Bottomed Out After Lift and Breast Augmentation

There are so many things I would need to know. Are you under the muscle or over? Do you have silicone or saline implants? What profile implants do you have? There are so many issues to give you the best answer. From looking at your pictures your breast does seem to have either bottomed out or you did not have enough of the lower pole skin and tissue removed. I have learned over the years that removing the lower breast tissue in a lift procedure while contradictory to a lift, is the tissue that will come back to haunt you and bottom out over time if it is not resected. If you feel the implant in your armpit then the pocket is too wide and may need to be closed down with suturing. Also, often times with implants as big as yours you might need a biologic product like Strattice or Alloderm to give you the support to the lower pole of the breast necessary to keep the implant held higher. There are many things that can be done to fix this but you are looking at another procedure and more money.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Am I Bottomed Out?

It is difficult to tell too much from these photos, but I can say that it does not look like there has been any bottoming out. This occurs when the implant descends below the breast fold, and that does not appear to be the case. 

A straight on photo and true lateral photos would help answer other parts of your question. If the implants are not positioned in a satisfactory manner, a surgical approach will be necessary to alter the pocket and perhaps choose different implants. 

Thanks for your question, best wishes.

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

Am I bottomed out?

I do not think you have bottomed out.  You do still have some glandular ptosis which results from your loose skin not supporting your breast tissue up like it used to.  Additional surgical lift can give improvement in profile. 

Andrew Stewart, MD
Charleston Plastic Surgeon
3.8 out of 5 stars 8 reviews

Am I Bottomed Out? Still Saggy and Flat a Year Later!

Very hard to determine exactly the issues from your posted photos. Seek in person second opinions from boarded P{Ss in your city. Good Luck. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Breast lift and implants

Thanks for the photos but the views are not complete.  An in -office exam woudl be essential. AS for lack of fullness superiorly, you may need wider implants?

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

This is not bottoming out.....

It appears as though your implants have slipped laterally from under your muscle.  This may be due to a very strong muscle, or very weak soft tissues lateral to your muscle.  This is more common in patients who have lost a lot of weight because their tissues tend to be a little more stretched out and allow displacement of the implant more easily.  I believe that sleeping flat on your stomach will also have a tendency to push your implants laterally as well.  The best thing to do is to have a revision surgery to move your implants medially, back under your muscles and to close the pocket laterally.  Your muscle may also need to be weakened as well to help prevent this from occurring again. 
Good Luck
Dr M

Daniel P. Markmann, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 113 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.