7 months post op, no upper pole fullness - am I bottoming out? (photos)

Dear nursej2,
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

From the photos submitted the implants are setting too low with the nipples pointing upward. A revision to tighten the lower pole of the breast should help. An exam is needed to give the proper recommendation, but mesh may be useful for you.

Yes, you are bottoming out a bit. The other issues with your shape are probably to do with the implant selection. For a given size, a high profile implant actually gives less upper pole fullness because it doesn't go as high up the chest wall as a lower profile implant. Based on the sizes you mentioned, I assume these are Allergan implants, so a 220cc implant would only be 10cm wide, which might be a little small for your base width as well. Assuming your base width is over 10cm (most people are), an implant that is slightly larger in volume and in width would help fill up your upper pole and medial breast, along with tightening the capsule to help with the bottoming out and to push the implant more medially.