Have I bottomed out? (Photo)

I had surgery April 22nd this year so it will be 6 months next week and they look very uneven to me. Have I bottomed out? Thank you

Doctor Answers 6

Have i bottomed out?

HI khampton,

  It seems that you have bottomed out. Sometimes this can happen if you do not wear good bra support for an extended period of time following the breast augmentation. It can also happen if the original tone to your skin was not good and your new implants are very heavy.

I would suggest that you see your surgeon to discuss your options. You may need a breast revision which could mean a trip back to the OR.


Dr. Christine Rodgers

Denver Plastic Surgeon
4.9 out of 5 stars 89 reviews

Have I bottomed out?

You do appear to have some bottoming out, worse on the right side. You will benefit from pocket plication and removal of more skin along the inframammary fold. This will improve your shape dramatically.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 72 reviews

Bottoming out

Thank you for your question. Yes look like they bottomed out. Please talk to your PS and corrective or revision can be performed.

Ven Erella, MD
Austin Plastic Surgeon
4.9 out of 5 stars 31 reviews

Have my breast implants bottomed out?

Thank you for your question.  It appears you have also had a breast lift in addition to implants.  The right side in particular does look as though it has bottomed out.  I would suggest that she discuss this with your plastic surgeon.  A revision can be done to lessen the distance from your areola to the inframammary crease. For more information please read the link below:

Bottoming out - please follow-up with your surgeon

I am sorry about the problems you are facing.

From your pictures, it does look like you are experiencing bottoming out.

Bottoming out is common when the inframammary fold is released and not firmly sealed and reinforced.

A weak inframammary fold will result in downward breast implant displacement once the breast implant slips below the natural or surgically lowered inframammary crease overtime.

Clinical signs:

·         Bottomed out implants end up too low on the chest wall with the inframammary scars travelling up onto the breast skin.

·         The nipples will not only point upward, but also be positioned higher on the breast mounds.

·         There will be no pain, but you may notice thinning of the skin at the bottom of the breast, which will allow you to more easily feel the breast implant.

It is good to be wearing supportive bras as this prevent further bottoming out. Supportive bras will apply upward pressure to the fold at the bottom of the breast.

To correct “bottomed out” breasts, a surgeon would need to secure the implant in an elevated position and then reinforce the implant capsule at the bottom of the breast with a suture technique. There may be a need for Acellular Dermal Matrix, a soft-tissue graft, in the repair. A smaller implant is often advisable, if the original was too large. In fact, receiving an implant larger than indicated by your breast characteristics and boundaries increases the risk of malposition. 

Please continue to have regular follow-ups with your surgeon to make sure your breasts are healing beautifully. Their recovery instructions should take precedence over all else you read here as they are better informed about your surgical details.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

Have I bottomed out?

I am sorry to hear about/see the problems you are having after breast augmentation/lifting surgery. I think your concerns are  appropriate; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”). Also, consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low.  

I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair).  This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly.  Associated issues with positioning of nipple/areola complexes should improve with this operation.

Make sure that the plastic surgeon who does this procedure for you can demonstrate significant experience with revisionary breast surgery.   

I hope this, and the attached link, helps.

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