Am I Bottoming out on Right Side 6 Months Post Op?

I am 6 months post op and received 210 cc saline implants. I am clearly bottoming out on the right side and am going back for another follow up in 4 months. My surgeon says he will correct the one side and that the other side is fine. I wanted to get a second opinion on this. Does the other side look appropriate? I also was wondering if this was caused by something I did or if it was a surgical error.

Doctor Answers 8

Bottoming out might require repositioning of the implants to a sub glandular position.

Sometimes sub muscular implants are pushed downwards by action of the pectoralis muscle. Bottoming out can occur in translocation to a sub glandular pocket will correct the problem.

Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Bottoming out?

Without knowing what you were like before implants, is difficult to comment but your photo does suggest it happening.   Your photos also suggest your volume may not be equal.  If you have to go back to the OR, you should make sure all of your concerns are noted so it may be corrected if possible.  Finally, to document bottoming out, measure the distance from your nipple to your fold and if its getting longer, you're definitely bottoming out.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Bottoming out?

It is always best to look at the preop photos to review your anatomy.  Just from the photos, it looks like the right is bottoming out.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Am I Bottoming out on Right Side 6 Months Post Op?

Yes you have very minor bottoming on the right side. But whether it was a anatomic issue or a surgeon's is impossible to determine. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Bottoming out?

Thank you for your question.  Yes, it is quite evident that you have some bottoming out of the right implant.  This is an unfortunate occurrence after surgery, but one that is correctable.  Looking for a "reason why it happened" can lead to frustration.  There can be several contributing factors.  There are several different methods for repairing the problem.  One solution that is often turned to first is to use a permanent suture to  stitch the tissue or capsule together to create a shelf for the implant to rest on, to prevent it from lowering too far.  Another method incorporates using other tissue--strattice, to create a shelf to support the implant. Meet with your surgeon, discuss the next surgery and I'm sure it will be carried out well. 

Good luck.


Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 36 reviews

Minimal bottoming out of a breast implant.

You do have some inferior descent of the left breast implant.  It is neither something you did or surgical error.  You have thin atrophic skin that, despite using a conservatively small implant, you still developed bottoming out.  It would be nice to see a pre-operative photo as well.  Overall you have a nice result.  It may be improved with an inferior capsulopexy and placement of fold sutures on the right side.   

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Breast Implant Revision

It does appear that the right breast implant is lower and has stretched out the skin below your scar.  After 6 months, the revision can be done at any time.  The left breast looks good and, in my opinion, does not need revision.

Lawrence Enisman, MD, FACS
Albany Plastic Surgeon
5.0 out of 5 stars 4 reviews

Correction of Bottoming Out of Breast Implant after Breast Augmentation?

Sorry to hear/see the complication you have experienced.   Unfortunately, these types of breast implant displacement problems can happen even in the best of hands. The breast implant displacement that you mentioned is clearly visible in the pictures you post. Finding “fault" ( something you or the plastic surgeon did incorrectly)  is probably not a worthwhile exercise.

 I think your plan is a good one. Waiting a few more months will allow the breast implant capsules to thicken to some degree ( and may help with the strength of the “repair”).  Allow additional time will also ensure that the left breast implant is in a stable position and will not require revisionary work at the same time.

Although your plastic surgeon will be able to provide you with specifics, it is likely that his plan will involve capsulorrhaphy; repair of the right inferior breast capsule with permanent internal sutures. This involves removal of a segment of breast implant capsule among the inferior/lower aspect of the left breast implant pocket. The 2 edges of  capsule tissue are sutured to one another with permanent suture. This procedure reduces the size of the implant pocket and prevents the descent  of the implant on the left side. This procedure will improve the symmetry of the breasts  and the positioning of the nipple–areola on the left breast mound.

 You may find the attached link helpful to you as you learn more about these types of procedures.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 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.