Is My Breast Botttoming Out Again?

I had my breast augmentation in july. I do not remember my CCs but i have saline and placed behind the muscle. Two months or so after the surgery i noticed my left breast was dropping lower than my right. I talked to my surgeon and he said my breast was bottoming out. I just had surgery about 5 weeks ago (dec 30th) and I believe my breast is once again bottoming out. Help, is it bottoming out once again?

Doctor Answers 20

Bottoming-out implant on one side after revision?

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Your arms-down photo shows an excellent result, but your arms-up photo does show a greater crease-nipple distance on your left compared to the right. At 5 weeks post-op it is impossible to definitively state that this will improve, stay the same, or get worse, but I do recommend a supportive brassiere full-time (day and night, except for gentle showering) to help support the healing tissues where your surgeon has tightened your pocket.

It is always easier to lower a pocket for too-high implant position when the implant settles and drops incompletely, or if the scar is tighter than anticipated. However, since we endeavor to create a thin, soft, pliable scar capsule around our patients' implants to give a soft, natural "feel" to the breasts, a too-low pocket position means we have to sew and tighten tissues that do not hold sutures well, and can stretch and tear-through with even minimal activity. Some asymmetry is normal, but re-operation can be necessary to improve position (and can take more than one re-operation).

Whether or not your left breast will require another procedure to further elevate the crease position is something you and your surgeon should decide together as time goes by. You could avoid lifting your arms when naked, but otherwise, this will likely need additional work.  Best wishes!

Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

I see no and bottoming out of your breast implant with arms down.

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Thank you for your question. With your arms down your result looks excellent and I don't see evidence of bottoming out. With your arms up you do see an increased nipple to inframammary crease distance. However at 5 weeks it is early in your recovery and this may improve. Be sure to consult your plastic surgeon

Is My Breast Botttoming Out Again?

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You do not appear to be bottoming out on your frontal view. You appear to have a normal amount of breast asymmetry, but it is impossible to determine what asymmetry you had pre-operatively without that image. There is some obvious asymmetry in the level of your breast fold with your arms raised. Asymmetry in the level of the fold is very common. It is possible that this asymmetry is normal for you and not bottoming out, but time will tell.

You are still early post-op and things will continue to change. The healing process can be frustrating and it is tough to know what to expect. Follow  up with your surgeon if you have concerns to make sure you are on track with your recovery.

Best wishes,

Michael Vennemeyer, MD

Bottoming out

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Since we don't have comparison photos over time it is difficult to judge. The distance from the right nipple to fold is longer than the left, and this could be bottoming out, or just relaxation after surgery. Certainly do not panic yet, but wait and see what happens. If it does not change over the next 6 weeks or so, then you will probably be happy. If it goes lower, then you may want it repaired again.

I Don't Believe You Are Bottoming Out Again

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The distance from your nipple to the inframammary fold is longer on the right than the left.  We don't have any pre-operative pictures, but this situation could have pre-dated your surgery.  Your nipple position looks good to me when you don't have your arms raised.  Slight asymmetries of nipple positions or inframammary fold positions are really the rule rather than the exception.  Bottoming out often has a double bubble as well.  You have no double bubble. 

I don't blame you for worrying after you had a revision already, but I think things are fine at this time.  Depending on how your plastic surgeon corrected the previous bottoming out, it might be useful to wear a bra 24/7 for about six weeks more to decrease any chance of truly bottoming out.  I know you are worrying and somewhat frustrated at this point, but I think you are okay and just support the good work your plastic surgeon did with a bra.  I believe you will come out of this just fine.

Recurrence of Bottoming Out?

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Thank you for the question and pictures.

With your arms by your side your breast implants appear to be in good position. With your arms raised however,  the breast implant malposition that you are concerned about is evident. At this point, it will behoove you to wear a supportive bra and to follow-up with your plastic surgeon.  Unfortunately, only time will tell if recurrent bottoming out of the breast implant will be an issue for you.

Best wishes.

Bottoming Out Not Really

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I feel your breasts look good with your arms at your sides and have not bottomed out. There is a difference in the height of the breast fold and nipple when your arms are raised. The right fold is lower and this may be have been present preop or the pocket could be lower. I would recommend waiting and wearing a good supportive bra and see your plastic surgeon.

Richard Linderman, MD
Indianapolis Plastic Surgeon

Bottoming out of breast implants

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The short answer to your question is no. There is nothing to suggest true "bottoming" at this point. It could still happen but it hasn't happened yet. 

"Bottoming" is a term used for a number of implant/breast contour problems but true bottoming is when the distance from the nipple to the inframammary crease stretched, the implant shifts too low into the lower pole of the breast, and the inframammary crease level rises onto the underside of the breast. 

Avoiding this problem and correcting it are best done through an incision in the inframammary crease -- one of many reasons to use this approach. 

The situation in your case is that the left breast is lower and more off-axis (turned out more) than the right and was almost certainly that way before the original augmentation but probably wasn't noticed. Breast implants do not lower or turn breasts out (if they are positioned correctly). 

In my experience, reinforcement with the strap of a bra in the inframammary crease does little after healing in the first two weeks but it isn't likely to harm either. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Good result

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I don't think you are bottoming out from the look of your pictures.  This doesn't mean that you wont bottom out or sag as time goes on but as for now, I think your results are good.

Bottoming out?

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At least from the photo on the right, it does not look like your breasts are bottoming out.  Just relax and enjoy the great result!

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.