Have my implants bottomed out or do I need a lift? (Photos)

Question

A huge goal of mine getting breast augmentation was to have breasts that sat perky and high. My boobs now look like bigger versions of my natural boobs and I still have to wear a bra with tank tops etc. There seems to be very little volume on the top of the breast with much more volume at the bottom. Have they bottomed out? Or should I be looking at getting a lift?

Donald R. Revis Jr, MD · Answer

Good afternoon,
You don't really have bottoming out or need a lift, but I would perform the Original Internal Bra, my strong permanent internal suturing technique, which would allow me to tighten up your pockets which increases cleavage and upper pole fullness. I first developed this technique over 20 years ago and today it is the most common revision I perform, 5-6 times a week- it works and it lasts!

Gary M. Horndeski, MD · Answer

At this time, you have large low breasts that are wider than the chest wall.  This does not give you the perky look you desire.  You are better off with smaller implants and a simultaneous lift.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Flexilexi890,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Because of your large implants, they have stretched your tissue and have dropped some. I would suggest going smaller and tightening the lower pocket.  If you stay the same size or go bigger, you will have the same problem perhaps sooner.

Karol A. Gutowski, MD, FACS · Answer

Based on the pictures, it looks like a good result. A breast lift will just leave you with scars. Perhaps seeing the "before" pictures and an in person assessment would be more useful.

Darryl J. Blinski, MD · Answer

Based solely upon posted photos your results are excellent for oversized breasts. If you desire more upper pole fullness I recommend liposuction 360 with upper pole micro fat transfer. Fee in the $8,000 +/- ranges.

Richard P. Rand, MD, FACS (retired) · Answer

You absolutely do not need a breast lift as your nipples are not low. Also, the incisions are right in the crease so you have not bottomed out. You might revisit your doctor and see if there is a higher profile style implant to give more volume in the upper pole. On the other hand, the bigger you go, the heavier the implants and the more they settle over time. Your result looks perfect.

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