Please Help!!! I Think Im Bottoming Out!

hello i am 6 wks post op. from the very beginning i have noticed that my right breast was a little different from my left. now that they have dropped my right breast is extremely different looking than my left. it is bigger and my nipple is higher. before my breast aug my left breast was the bigger one.. not by much but still bigger. I went to my surgeon last week and he said to start wearing a push up bra to stop them from dropping any more. will this really help?

Doctor Answers 6

Please Help!!! I Think Im Bottoming Out!

Thanks for all the posted photos, it really helps. I do not believe you have bottoming out, but a very good result with slight volume asymmetry. Either fill the left or deflate the right. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Breast Augmentation San Diego

Don't panic.  Breast implants are mechanical devices, NOT natural biological tissue.  Your skin envelope appears tight, and it will take time for the skin to relax and accommodate your implants.  The photos, in my opinion, show well positioned implants, and I agree with your surgeon that support may help prevent them from dropping further.  Many women experience some descent of implants after augmentation, and some do not.  Skin elasticity, surgical technique, soft tissue compliance, patient activity level, post surgical garments, thickness of periprosthetic capsule, and other factors influence this.  Sometimes, the implants drop vertically more than planned or desired.  Patiently wait several months, enjoy your new curves, stay close to your surgeon, and periodically re-evaluate.  If you are not happy with the appearance after 6-12 months of healing, review with your surgeon, and consider whether or not revsion is indicated.  Post your pre-operative pictures by your sink or on your desktop. What you now have is surely a significant step forward.  Perfection is an elusive goal.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Breasts bottoming out

In looking at your pictures, your Folsom appear symmetric but your right nipple is slightly higher. The left looks perfect so, the question is whether your right nipple was higher prep? When you ly down the right looks larger, again was it larger prep? The only other alternative is that there may be fluid in the pocket. You could consider an ultrasound.

Roger J. Friedman, MD
Bethesda Plastic Surgeon
5.0 out of 5 stars 7 reviews

Concerns about asymmetries following breast augmentation

Preoperative photos would have been helpful (as previously stated) in accurately explaining and answering your questions. However, even your earliest photo indicates that the right side is larger and the nipple is higher which continues across your sequence. If the same sized implants were used on both sides, then it is highly likely that your right side was larger preoperatively and your right nipple higher. You can inquire of your plastic surgeon regarding these issues.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Bottoming Out Breast Implants

It does appear that you have breast asymmetry, but I'm not sure if this is preexisting, related to different sized implants or a combination of both. However, your implants do not appear to be in the wrong position related to your frame. If the right implant is bigger, this could account for some of the differences you are seeing, but without pre-op pictures, only your surgeon will be able to answer this for you.  Contact your surgeon for more information, but the implant seems to be in an acceptable position from the photos provided.

Best of luck

Vincent Marin, MD

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

? Bottoming Out ?

Unfortunately, this is a common issue with Breast Augmentation.  Eighty percent of women are noticeable asymmetric when it comes to breast size, shape or nipple/areola positioning.  Often women don't notice this prior to getting breast implants, but after surgery, they are looking at their breast much more frequently and much more critically.  Unfortunately, you didn't include any before pictures to compare to, but implants don't change your nipple position. They can however exaggerate pre-existing asymmetries.  Your implant position looks pretty close to perfect.  You do have a slightly different shape to your breasts as well as nipple position.  The nipple positioning issue can be corrected by nipple pexy which involves a scar around the top of your left areola to move it up slightly.  But I'm not sure it's worth having this scar to correct this minor discrepancy. It all depends how bad it bothers you.  Size is a different issue.  I don't know if your surgeon used a larger implant on your right to compensate for that breast being slightly smaller and possibly overcorrected a little?  The only way to fix this would be to exchange one or the other of your implants for a slightly different size depending on which one you like the best.  But as far as your question about
"bottoming out"? I'd need to see a side view.  It does not look like it from the front view.  Wearing a push up bra or any properly fitting bra might help if you are truly bottoming out.   

Daniel P. Markmann, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 114 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.