Breast augmentation - what is the risk of bottoming out if I get implants? (Photo)

Question

I'm 26 I lost weight and had breast lift and TT a year ago, I'm planning on getting implants and did consultation with 2 surgeons who advised me to go with moderate plus above the muscle ~350-400 ccs. However I did more research and forgot to ask them about bottoming out! Will this happen if I get implants? I don't want my nipples to be higher. Please advise me.

Camille Cash, MD · Answer

Based on the photos and the provided information you are at risk for bottoming out.  It appears you will have the best outcome from revising your lift to remove excess skin from the bottom of the breasts and adding an implant.  Implants placed under the muscle have a few benefits to consider.  They carry a lower incidence of capsular contracture, the muscle helps to support the implant, and the muscle acts as a camouflage to the upper portion of the implant.  I've included a video I hope you find helpful.

Eric Swanson, MD · Answer

You have bottoming out. The operation for you is breast implants and a secondary vertical lift to cinch the lower poles. Your nipples should not be raised at all. The implants can go either below or above muscle. The key is the secondary breast lift to tighten your lower poles. The implants need to be placed correctly to give you the upper pole volume you want, so you look great naked or in a bikini.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t.  Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear sgrmk,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

Your previous breast lift was inadequate as the breasts are still low on the chest wall and you lack upper pole fullness.  The technique I recommend is a breast lift using The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Breast augmentation - what is the risk of bottoming out if I get implants? (Photo)

Answers (8)

Answer: Bottoming out

Answer: Bottoming out

Answer: Bellesoma Method

Answer: Bellesoma Method

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Everything you need to know about Breast Implants

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Breast augmentation - what is the risk of bottoming out if I get implants? (Photo)

Answers (8)

Answer: Bottoming out

Answer: Bottoming out

Answer: Bellesoma Method

Answer: Bellesoma Method

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Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.