Asymmetrical or still possibly bottoming out? (Photos)

My post op pictures alarmed me when I received them from my doctor. He sent me away after seeing me look like this. I posted those pictures to get an idea of how normal my progress was and almost all the feedback was that I had bottomed out in my left breast. These are pictures 6 months post op. Does the progress look normal now that more time has passed or should I return to my surgeon? And if I should...what do I say?

Doctor Answers 9

Settling has improve symmetry

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and you are not bottoming out.  If you are concerned about that, make a note of where the incision is in relation to your fold and if it starts moving upwards, you could be bottoming out.  Your nipples pre-op almost appear to be pointing inwards, suggesting you may have had a pectus excavatum and if so, your results are very good.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Breast Asmmetry

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Your first photo seems to be the most accurate pose, however, if your body is not straight which is the case in some of your photos it is hard to make an accurate diagnosis.  It does appear that your left breast is lower, but were your breast folds at different heights prior to surgery.  It also appears you have synmastia.  I would discuss with your PS.

Christopher Costanzo, MD
Thousand Oaks Plastic Surgeon
5.0 out of 5 stars 40 reviews

Breast Asymmetry

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Hello,You clearly had nipple position asymmetry that is aggravating your current appearance.  In addition your implants are too large, which is contributing to your symmastia. In addition, both implants are dropping out, one side more than the other. If your surgeon is not a ABPS certified/ASAPS member surgeon expert in revision surgery, you may want to go on a few second opinion consults.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews


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Thank you for the photos and the question and though you were clearly asymmetric prior to surgery, you appear to be bottoming out on one side and have symmastia on that same side but an examination is needed to confirm.

Dr. Corbin 

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Assymetrical or bottoming out

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Thanks for your question and photos.  Asymmetry between one's breasts is the norm.  It is always good to wait a good 4-6 months prior to considering a "final" result.  It is also important to acknowledge that you had some asymmetry to begin with.  Best to follow up with your PS to discuss expectations.  Good luck.


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It seems that there was some asymmetry on your preop photographs. When the breasts are larger and when they are examined more critically, the asymmetry is more obvious now. You can follow up with your surgeon, but sometimes the risk of revision surgery outweighs the benefits you may get.

Bottoming out

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Hello.  Thank you for your question and photos.  Your breast implants after 6 have settled down.   However the implants pockets may not be as symmetrical as they should be and the inferior disection is too low. That's what makes the bottoming out happen.  Go with your PS for a possible revision.

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 99 reviews

They look fine to me

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there is no substitute for seeing you in person and you do not provide 
details about your surgery. 
They look quite good to me.
It is rare to see a woman whose breasts are exactly the same.
Also it is very easy to find a surgeon, who will criticize another 
surgeons work, which is unfortunate.

you have had a wonderful improvement to your figure
compared to your pre-op photos. i think you should be very happy 
with your results and try not to be overly critical. 
none of us are perfect in our bodies- what we should be striving 
for is an improvement and you have had a huge improvement 
in your figure and what you can wear.

enjoy your excellent results.

david berman md

"Bottoming out of breast implants" may be in the eye of the beholder…

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Thank you for the question and pictures. Interesting question to answer: on the one hand, the breast implants seem to have settled symmetrically.   On the other hand, your breast implants do seem somewhat low on your chest wall, thereby making the nipple/areola complexes seem somewhat high on each breast mound.

The main question is: does the breast implant positioning concern YOU.  If so, then  technically you have mild breast implant bottoming out and revisionary breast surgery (capsulorraphy) will be necessary to improve the breast implant position.  On the other hand, if you are pleased with the outcome of surgery, then I would say your progress is "normal" and you should enjoy the outcome of the procedure performed.  In other words, what really matters here is your assessment (not that of other people, including online plastic surgeon consultants).

I hope this helps.

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.