just over 2 years now and iv got a problem iv got bottoming out of both breast and they have become very very saggy. i asked for a DD enlargment and got G-H breasts. Iv got no right nipple function or sensation on the lower part of my breast. the surgeon has reconmend a breast lift with a smaller implant. iv been looking and found i would like a medical cleavage and upper pole fullness with high profile implant im 22, uk.8 up top 10 bottom half. im 5.3 can someone help please? thank you.
Will Breast Lift Solve Bottoming out / Too Large Implants?
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Doctor Answers 15
Remedy for Bottomed out Breast implant
- Textured implants (“Velcro effect”)
- Use of Smaller Implants
- Maximum Submuscular Position (not just the pectoralis major but abdominis rectus below and serratus anterior on the side)
- Capsulorrhaphy (tightening the pocket by sewing in-folded capsular tissue together)
- Use of Biologic fabrics and other materials such as Acellular Dermal Matrix, “ADM” Alloderm, Strattice, “Silk” and others that can be used to reinforce the bottom of the pocket.
- Change of position of implant to a new pocket location “neo pectoral pocket”
- Internal Ryan Procedure (sutures binding the inferior mammary fold to stronger underlying tissues (e.g. fascial, periosteal)
- Removal of Implants and replacement of volume using your own fat (Fat Transfer).
Correction of Bottoming Out?
Thank you for the question.
Although not possible to give you precise advice without direct examination or viewing pictures, I think you may benefit from downsizing of breast implants, breast lifting, and possible capsulorrhaphy ( internal sutures used to close off the breast implant capsule).
In-person consultation with well experienced plastic surgeons will be helpful. Ask to see lots of examples of the surgeons
SEE VIDEO BELOW: Options for treating bottomed out and lifted breasts
In order to minimize the risk for recurrent bottoming out, you will likely need an inferior capsulorraphy with or without acelllular demal matrix and consideration of smaller implants.
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Bottoming out solutions?
Were your implants placed "on top" of the chest muscle? Were they saline or silicone? Smooth or textured? "Bottoming out" is generally defined as an elongation of the distance between the nipple and the inframammary fold (junction of the breast with the chest wall). The nipple progressively points upwards or "stargazes". Correction of this condition is difficult and can include downsizing the implant, converting it to another pocket (subpectoral or neopectoral), suture reinforcement of the fold (capsulorrhaphy) and/or utilization of an acellular cadaveric graft to buttress the inferior pole.
On the other hand, if the breast has simply sagged, a surgical solution should include downsizing the implant, possibly converting it to another plane as well as substitution of a textured surface and a breast lift to reduce the excess skin. good luck.
Bottoming out affect
Bottoming out represents too much implant in the lower pole of the breast and a pocket that is too large in the lower pole. You want more upper pole fullness and a nice cleavage. Your cleavage will be defined by the diameter of the implant. A higher profile implant will have a more narrow diameter, thus giving less cleavage. If the implant is smaller this also narrows the breast and results in less cleavage. In your case a significant resection of the capsule. All of these measurement variables will change your result.
Tal Raine MD
Long term consequences of large breast implants
Unfortunately, you are seeing the long term effects of an implant which may be too large for you body.
I agree with a much smaller implant and a breast lift.
Implants and lift
Yes, the larger the implants the more likely sagging will come into play over the long haul. A lift and smaller impalnt may be the solution.
Large Breast implants = Breast Sagging
Seek consultation with a local plastic surgeon
Your problem is not rare and surgery can help.
You may require a breast lift (mastopexy) and reduction of your current implant size. Unfortunately, your sensation and nipple function may not return.
You should fully discuss your options with a local plastic surgeon, including implant type, scar location and expected results.
Revision of bottoming out after breast augmentation
Bottoming out may occur when the weight of the breast stretches out the skin and causes an unattractive protrusion of the lower aspect of the breast. Without photos, it is difficult to assess exactly what the problem is in your particular case, and hence the best surgical correction. Breast lift will reposition the breast tissue and also allows removal of any excess skin from the inferior aspect of the breast.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.