Dear Doctors, I've had a slight concern about my nipple and whether it sits slightly high on my breast mound. It has been 6 months post op. I'd like to have your professional opinion on whether you think my breast implants have bottomed out.
Can you tell just by looking at the implants whether they are bottoming out, or are there other considerations? How do you know when it is time to call your surgeon?
Answer: The distance between the bottom of the areola and the inframammary fold determines if an implant is "bottoming out".
In a "C" cup breast, the distance from the areola to the crease is about 6 cm (3 inches), slightly more for "D" cup. If the distance in 2 cm or so longer, the volume of the breast will appear well below the horizontal axis. This is most commonly seen in submuscular implants where the vector of the pectoralis muscle pushing on the implant stretches the capsule and creates this problem.
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CONTACT NOW Answer: The distance between the bottom of the areola and the inframammary fold determines if an implant is "bottoming out".
In a "C" cup breast, the distance from the areola to the crease is about 6 cm (3 inches), slightly more for "D" cup. If the distance in 2 cm or so longer, the volume of the breast will appear well below the horizontal axis. This is most commonly seen in submuscular implants where the vector of the pectoralis muscle pushing on the implant stretches the capsule and creates this problem.
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CONTACT NOW Answer: How To Tell If Breast Implants Bottom Out If you believe you have a complication, the first thing you should do is see your doctor and have them examine you. Imagine drawing a horizontal line across your nipple. Above that line is referred to as the “upper pole” of the breast, and below that line is the “lower pole”. A round implant should sit evenly within the lower and upper pole, so that the nipple is at the center of the implant. Bottoming out is a complication in which the implant falls below the inframammary fold (breast crease), and hence, more of the implant is in the lower pole. This will cause the implant to look low and possibly, cause the nipples to point up. Have your physician examine you to determine whether your implants have bottomed out or whether their placement is within normal bounds. Your doctor will measure the distance from your breast crease to your nipple to make this determination. I hope that answers your question on implants bottoming out. It’s great that you’re doing this research. I always say that the best patients are informed patients. You might also want to research your options for breast implants. Choosing the right implant is the number one concern among women considering breast augmentation. Did you know, there’s actually a way to select a implant shape, size, and profile that is perfect for you? A term that I use with my patients for the perfect implant is the “Pony Implant”. So what do I mean by “perfect”? Well, a Pony Implant has three qualities to it. First, the implant meets your beauty goals. For example, you want to your breasts to look fuller while still appearing natural. Second, when you chose your Pony Implant, you walk out of your consultation 100% confident that you’ve chosen the right shape and size for you. In other words, you won’t be second guessing your decision, and you won’t be afraid of having gone too big or too small. And third, after your procedure, you are thrilled with your results, and say, "I’m so happy. This is exactly what I wanted!" That’s the Pony Implant. And the great news is that there is a simple process to go about finding yours. This issue of selecting the right implant is so important when it comes to patient satisfaction or dissatisfaction that, again, I really encourage you to learn more about it. Thank you for reading and best of luck on your journey!
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CONTACT NOW Answer: How To Tell If Breast Implants Bottom Out If you believe you have a complication, the first thing you should do is see your doctor and have them examine you. Imagine drawing a horizontal line across your nipple. Above that line is referred to as the “upper pole” of the breast, and below that line is the “lower pole”. A round implant should sit evenly within the lower and upper pole, so that the nipple is at the center of the implant. Bottoming out is a complication in which the implant falls below the inframammary fold (breast crease), and hence, more of the implant is in the lower pole. This will cause the implant to look low and possibly, cause the nipples to point up. Have your physician examine you to determine whether your implants have bottomed out or whether their placement is within normal bounds. Your doctor will measure the distance from your breast crease to your nipple to make this determination. I hope that answers your question on implants bottoming out. It’s great that you’re doing this research. I always say that the best patients are informed patients. You might also want to research your options for breast implants. Choosing the right implant is the number one concern among women considering breast augmentation. Did you know, there’s actually a way to select a implant shape, size, and profile that is perfect for you? A term that I use with my patients for the perfect implant is the “Pony Implant”. So what do I mean by “perfect”? Well, a Pony Implant has three qualities to it. First, the implant meets your beauty goals. For example, you want to your breasts to look fuller while still appearing natural. Second, when you chose your Pony Implant, you walk out of your consultation 100% confident that you’ve chosen the right shape and size for you. In other words, you won’t be second guessing your decision, and you won’t be afraid of having gone too big or too small. And third, after your procedure, you are thrilled with your results, and say, "I’m so happy. This is exactly what I wanted!" That’s the Pony Implant. And the great news is that there is a simple process to go about finding yours. This issue of selecting the right implant is so important when it comes to patient satisfaction or dissatisfaction that, again, I really encourage you to learn more about it. Thank you for reading and best of luck on your journey!
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December 13, 2016
Answer: About Breast Implants "Bottoming Out" "Bottoming Out" is the term given to implant #displacement, where the implant drops down below the existing inframammary fold; the natural crease beneath your breast. This may occur when the fold has been released excessively during surgery or may be due to factors of the patient’s collagen and tissue integrity. The implants then sit very low on the chest with a lack of internal support for the implant itself.Correction usually involves #restoring the crease beneath your breast to it's normal position with internal reconstruction of the capsule around the implant (#capsulorrhaphy). Sometimes a biologic fabric (Acellular Dermal Matrix or #ADM) can be used to attach to the breast tissue internally while supporting the implant.This corrects the placement of the implant, redefines the breast shape, and also refines the internal fold. However, it is best to consult with your Plastic Surgeon to better confirm with an in-person exam.
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CONTACT NOW December 13, 2016
Answer: About Breast Implants "Bottoming Out" "Bottoming Out" is the term given to implant #displacement, where the implant drops down below the existing inframammary fold; the natural crease beneath your breast. This may occur when the fold has been released excessively during surgery or may be due to factors of the patient’s collagen and tissue integrity. The implants then sit very low on the chest with a lack of internal support for the implant itself.Correction usually involves #restoring the crease beneath your breast to it's normal position with internal reconstruction of the capsule around the implant (#capsulorrhaphy). Sometimes a biologic fabric (Acellular Dermal Matrix or #ADM) can be used to attach to the breast tissue internally while supporting the implant.This corrects the placement of the implant, redefines the breast shape, and also refines the internal fold. However, it is best to consult with your Plastic Surgeon to better confirm with an in-person exam.
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November 6, 2018
Answer: Bottoming out implants Thank you for sharing your picture and question. Upon reviewing your picture it appears that your implants are slightly bottoming out. At this point, I recommend going back to your surgeon for an in-person evaluation so he can better assess your bottoming out. As far as bottoming out surgery goes, in order to repair bottoming out implants I will either close the pocket with internal sutures or restore and support the breast pocket using Strattice™ Reconstructive Tissue Matrix (sterile tissue derived from porcine skin), which is designed to support tissue regeneration. Strattice secures the implant location to reduce future migration problems. After your breast implants bottoming out repair surgery, your breasts will look elevated and symmetrical again.I have attached a link to more information about bottoming out implants for you to review. Good luck!
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CONTACT NOW November 6, 2018
Answer: Bottoming out implants Thank you for sharing your picture and question. Upon reviewing your picture it appears that your implants are slightly bottoming out. At this point, I recommend going back to your surgeon for an in-person evaluation so he can better assess your bottoming out. As far as bottoming out surgery goes, in order to repair bottoming out implants I will either close the pocket with internal sutures or restore and support the breast pocket using Strattice™ Reconstructive Tissue Matrix (sterile tissue derived from porcine skin), which is designed to support tissue regeneration. Strattice secures the implant location to reduce future migration problems. After your breast implants bottoming out repair surgery, your breasts will look elevated and symmetrical again.I have attached a link to more information about bottoming out implants for you to review. Good luck!
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June 22, 2016
Answer: Breast Implant Bottoming Out Thank you for your question. This condition is a form of Implant migration. Although, it can be seen with all types of augmentation. It is more common with violation of natural mammary crease of the breast and/or too large of an implant. Hope this helped, best of luck!Dhaval M. PatelDouble board certifiedPlastic surgeon Hoffman EstatesBarringtonOakbrookChicago
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CONTACT NOW June 22, 2016
Answer: Breast Implant Bottoming Out Thank you for your question. This condition is a form of Implant migration. Although, it can be seen with all types of augmentation. It is more common with violation of natural mammary crease of the breast and/or too large of an implant. Hope this helped, best of luck!Dhaval M. PatelDouble board certifiedPlastic surgeon Hoffman EstatesBarringtonOakbrookChicago
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August 1, 2016
Answer: Are you bottoming out? You should make an appointment with your surgeon for an in person consultation. If you are bottoming out then here is some information which could help you. Large Implants due to their weight, gravity, thinning of tissues, chronically not wearing a bra, loss of elasticity and other factors may cause continued stretching so that your breast implant is no longer supported in its ideal position. This results in the progressive lowering of the inferior breast crease (inframammary fold). When the implant moves South to an undesired inferior position it results in the loss of volume and flattening of the upper pole of the breast, too much volume at the lower pole, increasing the distance from the fold to the nipple and finally the nipple position being abnormally high ( pointing up) and not centered. Similarly, the pocket can also stretch to the side (lateral) so that when lying down your implants fall towards your arm pits or sides, causing the “Side Boobs” appearance.Bottoming out and Side Boobs Contributing Factors:Larger/Heavier ImplantsImplants placed above the pectoralis muscleChronically not wearing a bra when uprightOver dissection of the Implant PocketSmooth ImplantsLarge swings of weight including pregnancySkin and soft tissue laxity, loss of elasticity#bottomingout#breastaugmentation
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CONTACT NOW August 1, 2016
Answer: Are you bottoming out? You should make an appointment with your surgeon for an in person consultation. If you are bottoming out then here is some information which could help you. Large Implants due to their weight, gravity, thinning of tissues, chronically not wearing a bra, loss of elasticity and other factors may cause continued stretching so that your breast implant is no longer supported in its ideal position. This results in the progressive lowering of the inferior breast crease (inframammary fold). When the implant moves South to an undesired inferior position it results in the loss of volume and flattening of the upper pole of the breast, too much volume at the lower pole, increasing the distance from the fold to the nipple and finally the nipple position being abnormally high ( pointing up) and not centered. Similarly, the pocket can also stretch to the side (lateral) so that when lying down your implants fall towards your arm pits or sides, causing the “Side Boobs” appearance.Bottoming out and Side Boobs Contributing Factors:Larger/Heavier ImplantsImplants placed above the pectoralis muscleChronically not wearing a bra when uprightOver dissection of the Implant PocketSmooth ImplantsLarge swings of weight including pregnancySkin and soft tissue laxity, loss of elasticity#bottomingout#breastaugmentation
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