Does Breast Implant Profile Matter in Preventing Bottom Out?

Implant size, not implant style, may have more to do with bottoming out in your case. Once the inframammary fold is repaired or reset, a smaller (and therefore lighter) implant will help prevent this problem from recurring in the future. The difference between high profile and moderate plus profile is a matter of millimeters. The most important treatment here is the surgical repair of the fold, not so much the implant style choice.

Larger implants are heavier and therefore more likely to migrate downward causing bottoming out. Textured implants adhere more and are less likely to do so. 

"Bottoming out" is a term that originally came from breast reduction surgery.  Post-op, we would notice that, over a year or more, the lower half of the breast stretched out, while the nipple position maintained itself pretty well.

While this can happen after augmentation, due to a heavy implant, or stretchy skin, some surgeons confuse this with descent of the implant pocket or  "pocket expansion", which is a different situation.  Here, the implant drops lower, acting like a wedge between the skin and the chest wall, opening up the tissues.  Essentially, the implant is sliding down the rib cage, and the level of the inframammary fold descends, and the nipple starts to point upward.

Based on your information, I can't tell which of these problems you have:  inferior pocket expansion or true bottoming out.

The treatments are different for the two problems - which is why it's important to make an accurate diagnosis.

But no, implant profile by itself has not been linked to a higher rate of bottoming out.

Higher profile implants may actually cause you to have less cleavage and greater distance between the breasts.
Breast implant contour will probably have little effect on the bottoming out. However, surface contour may have a slight effect. Textured implants may diminish this tendency but are becoming increasingly less popular.

Hi,
Thank you for your question.
If you want to avoid bottoming out, I would not go bigger. This will only increase your chances of bottoming out because the weight on your breast will be heavier! Textured implants do aid in the reduction of bottoming out; however, they do come with some downsides such as creating a more noticeable rippling effect if your tissue is too thin and not being as mobile. You do have some other options such as a capsular repair to help hold your implant in place and prevent bottoming out. Explore these options with your plastic surgeon. Going bigger is not always the answer.
Best regards,
Dr.Speron

I don't think so.

There are two key factors in preventing bottoming out. One is the adherence of the implant to the surrounding tissues. Textured surface implants are ideal for this as they adhere to the surrounding tissues like velcro. They are not a perfect solution as they can help create visible rippling if the soft tissue cover over the implant is thin.

Another way to prevent drop out, or bottoming out, is to do a stitching of the capsule to anchor the bottom of the capsule securely to underlying tissues.

A third way is to create a support muscle sling using the muscles from the lateral and upper abdominal wall. I use this technique on both primary and secondary breast augmentations, but occasionally I use the capsule repair technique.

The video below talks about the issues of rippling and implant placement.

“bottoming out”  is the term used to describe the condition which occurs when the breast tends to look as if it has descended on the chest wall after previous surgery,  whether the surgery involved implants, a lift, or a reduction.  In the case of “bottomed out” implants,  sutures can often be placed in the lower pole of the breast to re-elevate the breast on the chest wall.  This is called a capsullorraphy and can achieve excellt results in the correction of “bottomed-out implants.

Many factors can cause breast implants to bottom out.  Women with extra large implants are at highest risk of having breast implants bottom out. This is one of many reasons I don't use extra large breast implants in my plastic surgery practice

Going with a larger implant will surely put you at risk for further bottoming out. Bottoming out is a combination of your skin tone and size of the implant. The larger the implant is, the more bottoming out you will notice. If you already have this issue, you should discuss with your surgeon revision of the implant pocket and actually going with a smaller implant to avoid future problems. Over the last 10yrs your skin has aged and the tone decreased. Changes to your skin as a result of aging should also be taken into consideration before choosing a new implant size.

Bottoming out with implants can be the result of multiple things. This can include poor skin tone, very heavy large implants, age, gravity, violation of the inframammary fold to name a few.