Am I Bottoming out Why Do I Have Indention and Odd Side Shape when I Raise my Arms? (photo)

I had mastopexy with implants in jan, i wanted a d cup and was barley a c so i had a revision in april, I switched from silicone to saline bec i wanted upper pole fullness, which i still dont have...anyway, on my left breast i can really feel the implant sack in fact i can grab and pinch the implant shell and i have a funny looking indention... the problem gets worse when i raise my arm....just curious on opinions.......

Doctor Answers 4

Mastopexy-augmentation bottoming out

The combination of augmentation and breast lift has a relatively high incidence of requiring at least minor revisions and the overall results shown in the pictures are not bad. One thing that might help sort out the issues you describe is whether there is any animation, which would be pulling upward at the location of the indentation when you flex your pectoral muscle. If that is the case then simple procedures such as capsulorrhaphy may not work long-term, and you may want to look into options specific for that.

Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Am I Bottoming Out after Breast Augmentation/Lifting Surgery?

Thank you for the question and pictures.

Your concerns about breast implant position and distortion with movement are visible in the pictures you have posted.  It is possible that additional surgery involving internal suture support of the lower poles of the breasts (capsulorraphy) may be necessary to achieve the results you are looking for.

 Generally speaking, many patients who wish to maintain long-term superior pole volume/"roundness" may find that this result is not achieved after the initial breast augmentation/lifting operation.  Again, an additional operation, possibly involving capsulorrhaphy, may be necessary to achieve the patient's longer-term goals ( with superior pole volume/roundness).  It is helpful if patients understand that this breast implant capsule used to provide the support for the breast implant is not present during the initial breast augmentation/lifting operation.  The capsule (layer of scar tissue) forms around the breast implant and may be a good source of supportive tissue during revisionary breast surgery,  including correction of breast implant displacement/malposition problems ( such as bottoming out, symmastia,  lateral displacement etc).

You may find the attached link helpful to you as you learn more about options.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Am I Bottoming out Why Do I Have Indention and Odd Side Shape when I Raise my Arms?

The posted photos result is very acceptable. The upper pole issue could be correct via fat grafting. 

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

Am I Bottoming out Why Do I Have Indention and Odd Side Shape when I Raise my Arms?

It looks like you have a little scar contracture along the vertical incision on the left side. This is noticeable at rest and interferes with what otherwise appears to be a very nice result. There is no bottoming out that I can see. 

An actual exam would be far more helpful than a photo, but I suspect this can be improved with a scar revision done under local anesthesia. 

All the best. 

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

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