Will Breast Lift Solve Bottoming out / Too Large Implants?

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.

Doctor Answers 15

Remedy for Bottomed out Breast implant

Surgery is the only effective remedy. Revision surgery is almost always more complex than breast augmentation. Correction techniques vary based on your plastic surgeon’s experience and skill sets. Always choose a board certified plastic surgeon with expensive revision experience as even in the best of hands recurrence is frequent especially if larger implants are used. Repair techniques include some of the following techniques and recommendations:
  1. Textured implants (“Velcro effect”)
  2. Use of Smaller Implants
  3. Maximum Submuscular Position (not just the pectoralis major but abdominis rectus below and serratus anterior on the side)
  4. Capsulorrhaphy (tightening the pocket by sewing in-folded capsular tissue together)
  5. 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.
  6. Change of position of implant to a new pocket location “neo pectoral pocket”
  7. Internal Ryan Procedure (sutures binding the inferior mammary fold to stronger underlying tissues (e.g. fascial, periosteal)
  8. Removal of Implants and replacement of volume using your own fat (Fat Transfer).
The procedure is performed under general anesthesia on an outpatient basis most often using an existing scar or making an incision beneath the breast. Recovery is similar to your original breast augmentation procedure. Use of taping after surgery and prolonged use of a support bra is often recommended. It is far more important to pick the best plastic surgeon rather than trying to pick the best procedure as they are in the best position to guide you to the right decision.

Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

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

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

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.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

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.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

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

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

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.

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon
4.7 out of 5 stars 13 reviews

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Large Breast implants = Breast Sagging

All women would like having large breasts with cleavage that would stay perky forever. Unfortunately that is a physical impossibility. Gravity always wins and the more weight is piled into the breasts, the faster they will sag. To correct matters it is reasonable to reduce the volume of the implants and to lift the breastsalthough in the absence of examining you much less seeing a photograph it is hard to specifically address your situation. Good Luck. Dr.Peter A. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

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.


David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 75 reviews

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.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

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.