Am I Bottoming out and Will I Need More Surgery? (photo)

I am a 35 year old mother of two who is done having kids. I had breast augmentation 3 months ago, and am unhappy with my breast asymmetry. I have 275 cc silicone implants under the muscle. My right breast is less full on top and my incision has moved up onto the underside of my breast. Am I bottoming out? Or will the left breast drop as well? I have an appointment with my board certified plastic surgeon soon, but am anxious for information.

Doctor Answers 8

It sounds like one implant may have dropped lower than the other

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From your photo and your description it may be that that implant has dropped down a little below the lower border of where the breast pocket was intended to be.  If this is the case repairing the pocket can be performed well under local anesthesia in experienced hands.  Waiting longer may be beneficial as the implant capsule will have more time to form.  In the meantime I would encourage use of a proper fitting underwire bra.  This will help to minimize further opening of that pocket.

All the best,

Dr Remus Repta

Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Bottoming out after surgery

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Thanks for your question, without a pre-op picture it is hard to evaluate your asymmetry which I agree with you I see.  However, I do not know if these asymmetries already existed pre-op.  Please keep communicating with your surgeon and best of luck.

Asymmetry is the issue after augmentation

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The breast augmentation does indeed look good, not perfect but very good. The issue is probably in the difference in the skin envelope right to left, as the implant appears centered on the nipple and not low or bottomed. If you measure from the fold to nipple on each side one side will be longer. It is best to support the breast with an underwire, and wait six months to see how things work out.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Bottoming out?

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Though you do have some asymmetry, it is too early to tell if this will be the final result or if you really do have bottoming out.  Your breasts look good, but a pre op photo would be helpful to really evaluate things.  You should give yourself more time to heal and discuss your concerns with your surgeon.

Leonard T. Yu, MD
Maui Plastic Surgeon

Breast Asymmetry after Breast Augmentation

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Thank you for the photos.  Your concern that the right breast appears to be 'dropping' more so than the left side is a real possibility.  If your breast folds were at the same location pre-op, and now the right fold is lower than this indicates that you are experiencing a 'bottoming-out' of the right breast.  This also can explain why there is less upper fullness on the right because the implant is sitting lower than on the left side.

Your plastic surgeon can give you a definitive answer upon evaluation.  Most importantly, remember that there are options available to address your concerns and improve your breast symmetry.


Best wishes!!

Louis DeLuca, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 58 reviews

Concerns about Breast Asymmetry after Breast Augmentation?

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Thank you for the question and pictures. Your pictures demonstrate your concerns nicely.

I would agree with you that your plastic surgeon will be in the best position to advise you after direct examination. I would suggest that you allow an additional 6 months to pass before evaluating the end results/positioning of your breast implants. If at that point, you notice significant asymmetry of the breast implant position,  then revisionary breast surgery may be helpful to you.  For example, if one breast implant has settled significantly more than another,  internal suture techniques (capsulorraphy)  may be helpful in improving the breast implant pocket symmetry...

 Best wishes.

Breast asymmetry

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Most women have some degree of breast asymmetry.  A breast augmentation will only make your breasts larger.  If you have some differences before surgery you will have them after as well.  Your photo actually looks good.  There may be a bit more fullness on one side.  I encourage all of my patients to wear a well supportive underwire bra after surgery in an effort to decrease bottoming out, which I think takes longer to occur than in your case. If you are considering a lift you will have to trade off the scars for the amount of improvement you will get.

continue to follow up with your surgeon.  Thank you for your question and the photos and best of luck.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 69 reviews


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From your pictures it looks like you have good looking results. Sorry it wasn’t what you expected. If you were looking to have perkier breast, a lift could of help make that happen. Asymmetry is very common in 95% of women.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

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.