Does Wearing a Bra Protect Breast Implants from Bottoming Out?

Do you have to wear a bra after breast augmentation for a certain period of time? Does it help keep your implants from bottoming out?

Doctor Answers 18

Bras and Bottomed out Breast Implants

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Hi there-

While I do believe that a good support bra is important after augmentation surgery (especially when implants are placed under the chest muscles), I don't think that the bottomed-out appearance, where there appears to be excessive skin showing between the fold under the breast and the nipple, can be prevented by using one. The primary cause of a bottomed out appearance would be violation or lowering of the inframammary fold structures (either deliberately or inadvertently) at the time of surgery.

In a minority of patients, an initially lovely result can over time appear more bottom heavy, indicating a possible need for a breast lift, but a truly bottomed out appearance soon after surgery would most likely be due to technique and not the bra.

Do bras prevent implant bottoming out?

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I don't think that anybody completely understands why the distance between the nipple and breast fold stretches out in a woman with breast implants. I have some women who've had pregnancies after implants, never wear a bra and still look like they did a week after surgery. But more often, women have the misconception that implants will eliminate the need to wear a bra. If you think about how women's bodies change with age, pregnancy, weight gain/loss, illness, you realize that gravity always wins and the breasts slide off the chest, as the nipples settle inferiorly.

Like other plastic surgeons, I think that wearing some support does help. I've asked some of my patients who have very large implants and have seemed to defy gravity. Their response is usually "I protect "the girls"/"my investment" by wearing supportive garments. Until the processes of aging are better clarified, I think that bras do probably help. Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 59 reviews

Bras may prevent bottoming out in many

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My experience after nearly 3 decades of observation is that in many cases bra wear most days in general do help prevention of bottoming out over the life time of the implant. This applies to all implants and especially with smooth implants that are place over the muscle (subglandular). They of course would not be of benefit at night as gravity and implant weight is not at work pulling the implant downward.


Compresssion Bras Following Breast Augmentation

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There doesn’t appear to be a consensus amongst plastic surgeons regarding the use of bras following breast augmentation surgery. Many plastic surgeons tell their patients it doesn’t make a difference while others tell their patients that bras are an absolute necessity in the post-operative period. Unfortunately, there are no scientific studies that clarify this issue.
A complex relationship exists between breast tissue, wound healing biology, breast implants, and gravity in patients who have undergone breast augmentation surgery. It makes sense that breast implants can exert significant downward pressure on the soft tissue of the breasts. Over the course of time, this might lead to soft tissue stretching and bottoming out of breast implants.
For this reason, we feel it’s appropriate to wear a bra for support following breast augmentation surgery. This is especially true when larger implants have been used and placed on top of the pectoralis muscles.
It’s important to realize that each patient’s situation is unique. For this reason, postoperative care should be individualized. Under these circumstances, it’s appropriate that you discuss this issue with your plastic surgeon. Your surgeon should be able to formulate a treatment plan that’s appropriate for you.

Bra wear after augmentation protective?

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Dear Liezle,
Thank you for your post. I am very protective of my patients with augmentations or lifts who are runners. I recommend that they buy the athleta underwire sports bra with the front adjustable straps. My patients really like this bra for running and find that it holds them very stable. It is cupped instead of compressing the breasts together. Some patients use an additional regular sports bra on top of this for extra security. Some like it for everyday wear in the initial post-operative period. Using a regular sports bra that just compresses the breast together rather than cups that keep their shape can cause flattening of the breasts especially in the early post operative period and wearing a bra that doesn't have enough support, especially when running or any bouncing type activity, can cause bottoming out or stretching of the breasts. Non-runners have less of a concern, but if the implants are big enough, gravity will have an eventual effect, so daily bra wear is recommended as well.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Bottoming out of breast implants usually caused by implant placement

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It is important to wear a support bra after breast implant surgery, but usually I have my patients go bra-less after the first day or so.

Bottoming out of implants can happen if you have very thin skin with insuficient dermal elastic tissue. However, wearing a bra 24/7 is impractical and probably won't help if you are going to eventually bottom out.

If you have good skin and your implant is placed properly, then you should not bottom out.

The reason that I have patients go bra-less the first few weeks and do displacement exercises for life is that the nmost common breast implant position probelm is that the implant is too high and does not fall into a natural position-in my experience.

If your implants bottom out soon after surgery then the implant was likely placed too low at surgery.

Breast implants and bottoming out wardrobe

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Bra's after breast augmentation generally speaking are for support. They help support the weight of the implant to offload the newly operated breast tissue. They can support bandages in place, if they were used. They support the patient emotionally so that they feel that their newly enhanced breasts are stabilized and seated motionless where they were assigned.

The operation is what places the bra in the correct position, not 'medical grade' undergarments. The patient's tissue response and the precision of the surgery are what count. Just like the implants can't be relifted by a brassiere, they also can't be dropped by a band (another medical grade garment commonly used after surgery). Massaging can help soften a scar and position the implant more favorably but for the most part, the masterpiece was created during surgery. That's why we don't leave the OR until they're picture perfect.

A tincture of time is a good prescription that can help implants drop, sink, settle, soften, shrink, and all kinds of southbound transformations .. but even time can't reverse bottoming out (no matter how hard we wait, hope and stare visit after visit). Bottoming out will not correct with tape, walking on your hands, a bustier or even the above mentioned tincture of time. Sorry, but only a quick visit back to the OR can fix that. I've had to do this on rare ocassion and it has worked out quite well so don't lose hope for those of you that read this with bottomed out implants.

This being said, most of us use bra's on our patients after surgery (sometimes). I'll finish the case, look at the result and dictate "No bra". Others, it'll be "No under wire bra". Typically, it's "Bra for 6 weeks".

Regardless of the instructions that I dictate at the end of every breast augmentation, most patients come back on post op day 7 with a smile and their bra neatly folded in a ziplock and ask "did you want me to wear this?" .. and they're fine.

Ricardo A. Meade, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 125 reviews

Bras provide support

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Yes - a bra will help prevent your implants from "bottoming out". The main issue is your choice of implant size. If you chose very large implants, they will have more of a chance of dropping than moderate sized implants. A bra will help with either implant, as the elastic support of the bra will prevent the skin from feeling all of the stretch caused by gravity and the implants.

Wearing a bra after breast augmentation

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Wearing a bra can help support the skin envelope holding up the implant. So, I would recommend wearing one as much as you can during the day. Also, working out may stress the implants and cause the skin to stretch out faster. Therefore, make sure you have excellent bra support while doing any aerobic activity.

Time, weight and gravity are factors which lead to bottoming out

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In most cases a bra or any other external garment will not make much difference in the final outcome. The quality of the patent's tissue is the most important feature followed by the size of the implant. Too large of an implant in a patient with poor tissue quality will eventually lead to an implant that bottoms out.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 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.