I'm 40 yrs old. Will I Bottom Out? (photo)

I am concerned about "bottoming out" after BR surgery. I'm 40 and have always had poor muscle definition despite regular exercise. Who is more prone to this condition and is there any style of surgery more likely to have this happen (e.g. inferior vs superior pedicle)? Thanks :)

Doctor Answers 8

Bottoming out after breast reduction

I have been doing vertical breast reductions for at least 10 years and I think they really do hold up better than the inferior pedicle with an anchor incision.  I think this is because the lower part of the breast is resected and then the remainder shaped.  This technique does not depend on a "skin bra" to shape the breast. 

That being said .......  All breasts go south with gravity, age and time.  Fatty breasts go south faster than fibrous breasts and large breasts go south faster than small ones. 

That being said ......... Breast reduction patients are almost always thrilled being smaller and more comfortable and a great bra can cure bottoming out if it does occur.

Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Bottoming out after breast reduction

Bottoming out after breast reduction sometimes occurs regardless of the technique used.  There are surgeons who will tell you that you chances are better with a superior pedicle techniques, but I don't find that the case.  

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Lollipop scar breast reduction helps prevent bottoming out.


1)  This operation is VERY dependent on technique.  Traditional surgery (anchor scar) shapes the breast by pulling on the skin.  But skin stretches and you often get bottoming out.

2)  For most women, the vertical (lollipop scar, Lejour technique or Hall-Findlay technique) breast reduction gives the best long term shape because it shapes the breast INTERNALLY without relying on skin tension.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Will I Bottom Out?

The answer depends to a great deal on the quality of your skin elasticity. Muscle tone has nothing to do with the breast drooping or not. Find a very experienced surgeon and discuss your concerns with him and after an exam he should be able to answer your question.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Bottoming out from breast reduction

A breast  can sag after a reduction and it really depends upon many factors,. Overtime it will eventually happen, but sooner for some than others.

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

Bottoming Out after Breast Reduction?

Thank you for the question and picture.

 I do not think that you necessarily, based on any concerns of “poor muscle definition”, have to worry about any specific complication after breast reduction surgery. My best advice would be to choose your plastic surgeon carefully; ask to see lots of examples of his/her work and communicate your goals carefully.

 Best wishes;  I am sure you have heard that breast reduction is one of the most patient pleasing operations performed.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

With the right technique and surgeon you shouldn't bottom out after breast reduction

Muscle definition will not influence the final appearance of your breasts after a reduction. However, skin quality, pedicle, and types of incisions can affect the long term outcome of the breasts. Consult with multiple plastic surgeons in your area and find someone with whom you are comfortable, who has nice long term results. Thank you for sharing your photo and question. Best wishes.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 164 reviews

Will I Bottom Out?

     I perform a great variety of reductions with different pedicle techniques.  It is probably a fair statement to make that if the breast tissue is kept attached superomedially that less bottoming out occurs over time.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast lifts and reductions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 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.