Bottoming out twice after breast reduction surgery. Looking for advice

Question

I had my first breast reduction in September 2019. In March 2021, I had extra skin removed and scar revision surgery due to bottoming out. The lower portion of the breasts were visibly denser and no volume on top, with nipples sitting high. Now, a little over a year later, the problem is still there. I went to my surgeon and he suggested implants with an internal bra. I went to see a second surgeon and he said implants with a lift, no internal bra. I'm confused! What do you think? Thank you!!

Camille Cash, MD · Answer

If you have bottomed out multiple times it may be beneficial to add bioabsorbable mesh to support thin tissues.  A revision of the lift would be needed to correct nipple position and remove excess skin.  I've included a video that I hope you find helpful.

Daniel Barrett, MD · Answer

Dear fiji2021,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ashley Thorburn, MD · Answer

"Bottoming out" refers to a complication that can occur after breast reduction surgery when the breast tissue shifts or descends below the inframammary fold (the natural crease under the breast). It may result in a sagging or unnatural appearance of the breasts. If you've experienced this issue twice after surgery, it's essential to address it promptly and work closely with your surgeon to achieve the desired outcome.Here are some general tips and considerations:1.) Consult Your Surgeon: The first and most crucial step is to schedule a consultation with your plastic surgeon who performed the breast reduction. They can assess your condition and discuss the best course of action.2.) Consider Revision Surgery: Depending on the severity of bottoming out and your specific anatomy, your surgeon may recommend revision surgery. This could involve reshaping the breast tissue and providing additional support to prevent future bottoming out.3.) Follow Post-Operative Instructions: Make sure you're diligently following your surgeon's post-operative instructions for proper care and recovery. This includes wearing any recommended support garments, avoiding strenuous activities, and attending follow-up appointments.4.) Manage Expectations: Understand that achieving the desired breast shape and position may take time, especially if revision surgery is required. Be patient and maintain realistic expectations throughout the process.5.) Seek a Second Opinion: If you're unsure about the recommendations provided by your original surgeon, consider seeking a second opinion from another board-certified plastic surgeon. This can help you make an informed decision about your treatment plan.6.) Lifestyle Adjustments: Maintain a healthy lifestyle with a balanced diet and regular exercise to support your overall well-being and recovery.7.) Emotional Support: Breast surgery, especially revisions, can be emotionally challenging. Seek support from friends, family, or a therapist to help you cope with any stress or anxiety.Remember that each case of bottoming out is unique, and the treatment plan will vary depending on your individual circumstances. Discuss your concerns and goals openly with your surgeon, and together, you can develop a plan to address the issue and achieve the best possible outcome.

Bottoming out twice after breast reduction surgery. Looking for advice

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Bottoming out twice after breast reduction surgery. Looking for advice

Answers (3)

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Everything you need to know about Breast Reduction

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