Do Bottoming out Breast Implants Hurt?

Question

Last 2YRS when I lay down R implant is sliding down into armpit. I'm experiencing unbearable pain if the implant is shifted/moved. The pain is sharp, feels like burning and/or tearing of the skin. What should be done? Am I at risk? I'm worried cus of the pain, have yet to see posts about pain.

Otto Joseph Placik, MD · Answer

Occasionally bottoming out implants can cause stretching of nerves which causes pain and discomfort. Most commonly this is relieved when the implant is lifted and the tension on the nerve is eliminated. In some instances, an implant removal, replacement and capsulorrhaphy will provide relief.

Steven Wallach, MD · Answer

Yes, you have bottoming out, and sometiems pain can be associatesd with the tissues stretching or even a tight capsule.

Peter A. Aldea, MD · Answer

Thank you for the accurate and clear presentation of your problem. I truly sympathize with you. Having seen many women with similar issues in my training and in my practice it truly bothers me on an emotional level every time I am asked by an under-educated young woman HOW she can go from being flat chested to a DDDDD size or get the "fake boob" look - the result of such requests inevitably lead to your dilemma and much worse.

	Most breast sagging is either painless or accompanied by a dull discomfort similar to having a hernia. Your sharp pain may suggest a nerve irritation (Burning pain is a classic presentation and may be treatable with medications used for atypical pain).

	If you wanted this to be repaired, I would suggest you consider lighter implants (silicone gel) and is possible smaller volume. What is required here is to make the lower and side breast pocket smaller by stitching the scar around the implant to itself (Capsulorraphy). The problem is that such repairs do not always hold and many implants sag and sag asymmetrically. Another option  is to create a hammock with either Alloderm or Strattice - expensive biological sheets which WILL hold the implant securely in a higher position.

	Correcting the traction on the nerve may alleviate the pain. If you do not really care about the appearance and would prefer only the pain to be addressed you may need to see a pain doctor. The problem is that such medications will need to be taken for a long time and have many side effects.

	Good Luck.

Scott E. Kasden, MD, FACS · Answer

Bottoming out doesn't hurt.  You are having what sounds like nerve pain.  The other problems that you discuss, and have on your photo indicate that the implant pocket has stretched allowing for the implant to fall downward and to the side.

	I recommend that you see a qualified plastic surgeon and explore capsulectomy, pocket repair, with or without replacement.  If the implants are above the muscle, consider going under.

Do Bottoming out Breast Implants Hurt?

Answers (4)

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