Bottoming out Breast Implants? (photo)

I had my ba a little over a year ago (375 cc silicone gel, under the muscle, crease incision). I have minimal natural breast tissue. My question is: do my breasts look like they are "bottoming out"? I am very happy with the results and my ps... but my scars have seemed to travel up my breast about 1.5 cm each and there is a bit of asymmetry (i apologize for lack of a before-photo, i was too embarrassed to take any). I am not experiencing any pain at all and wear an underwire bra 24/7. Thanks!

Doctor Answers 14

Breast implant, bottoming out,


I think you have had a nice result and no, you aren't "bottoming out" in any of your photos. When your arms are down, your scars appear to sit nicely in the breast fold. Yous scars will always lift a little when you raise your arms. At rest your breasts have a great shape - and I think you and your surgeon have made a really good decision with your size. You also appear very slim and I suspect that if your implants sat much higher you would see the shadow of the upper pole of your implant against the ribs, and the bottom of the breast would have a sagging look.

I actually think you would be justified in feeling rather pleased with yourself.


Best Wishes

Sydney Plastic Surgeon
5.0 out of 5 stars 1 review

Am I Bottoming Out?

Dear SnowBoardChik,

Hello, and thank you for your question/photos.

First of all, you do not have a bad result.  That said, your implants are placed low on your chest.  I can say this because 1. you have a  lot of implant below your nipple, and 2. you have a significant indentation inbetween your pectoralis muscle and the implant.  In #1.  your nipples should be on the lower half of your breast to look natural.  In your case, the nipples are at or above the mid-portion of the breast.  In #2, you have a disconnect between your breast (implant) and your pectoralis muscle.  Where your pectoralis muscle curves from your under-arm across your chest, the contour indents and then your breast starts.  If your implant were placed higher, there would be no indent and there would be a smooth curve from the pectoralis muscle into the breast tissue, which is what a natural youthful breast will look like. 

As far as 'bottoming out', if the implants were higher 6 months ago, and now lower, then you are bottoming out.  If they are in the same place, then you are not, they just happen to be a little low.  The reason they could be lowering if they are, is that a smooth implant under the muscle has a tendency to lower because the muscle is constantly pushing the implant down as your chest muscles contract.  When you contract this muscle, it pushed firmly against your rib cage.  If there is something underneath it, like an implant, this gets pushed out, in this case down.  One way to help prevent this from happening is to use a textured implant.  With this kind of implant, the body grows into all the little millions of pores in the implant and 'glues' it into place.  This resists the force of gravity and the muscle pushing down. 

Please see this example of a girl who received a textured implant under the muscle.  Like you, she had very little tissue prior to surgery.  Notice the positioning of the nipples on the breast as well as the smooth contour from the chest muscle into the breast.

As I said before, however, you still have a nice result.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Bottoming Out

Hello there

Your breasts do look a little 'low-set' on your chest wall but despite this it may be possible to reopen your scars and tighten the lower implant pocket and resecure the incision in the fold .

Only intervene if it really bothers you though . All surgery has some risk .

I suggest you return to talk to your plastic surgeon to discuss the pros and cons .


Terrence Scamp

Terrence Scamp, MBBS, FRACS
Gold Coast Plastic Surgeon
4.8 out of 5 stars 7 reviews

Bottoming out?

It doesn't appear from your photos that you are bottoming out.  It looks like you have naturally lower sitting breasts and they may have settled a bit more to move your incisions up a touch.  Slight asymmetry is normal in everyone.  As long as you are happy with your results, that is what matters the most and it looks like you had a nice result.  ac

Angela Champion, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 5 reviews

Are you bottoming out?

You should make an appointment with your surgeon for an in person consultation. If you are bottoming out then here is some information which could help you.

Large Implants due to their weight, gravity, thinning of tissues, chronically not wearing a bra, loss of elasticity and other factors may cause continued stretching so that your breast implant is no longer supported in its ideal position. This results in the progressive lowering of the inferior breast crease (inframammary fold). When the implant moves South to an undesired inferior position it results in the loss of volume and flattening of the upper pole of the breast, too much volume at the lower pole, increasing the distance from the fold to the nipple and finally the nipple position being abnormally high ( pointing up) and not centered. Similarly, the pocket can also stretch to the side (lateral) so that when lying down your implants fall towards your arm pits or sides, causing the “Side Boobs” appearance.
Bottoming out and Side Boobs Contributing Factors:
  1. Larger/Heavier Implants
  2. Implants placed above the pectoralis muscle
  3. Chronically not wearing a bra when upright
  4. Over dissection of the Implant Pocket
  5. Smooth Implants
  6. Large swings of weight including pregnancy
  7. Skin and soft tissue laxity, loss of elasticity

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Bottoming out

Without a before I can not completely answer you. It appears that your breasts are low set naturally and the implant placement may have been perfect to account for that. The other is you have a mild case of bottoming out.

Michael Hueneke, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 63 reviews

Breasts bottoming out following breast augmentation.


The answer to your question is "yes," your breasts are bottoming out.  This phenomenon is usually more characteristic of saline implants, although may occur with silicone.  HYou do have options to the problem.  I would recommend either doing a wedge excision of skin in the fold area to possibly move the nipple down in conjunction with a capsulorrphaphy to tack the pocket down also.  I can't tell if the implant is too wide on your chest, may or may not be.  You chould choose to have an implant with a smaller diameter, but not alot smaller.  You didn't mention which projection you have (moderate, moderate plus or high profile).  If you chose to go to a narrower implant, you may chose a higher projection depending on the size you would like to have.  A Board Certified plastic surgeon  with experience should be able to resolve your problem.

Thank you,


Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 49 reviews

Bottoming out breast implants?

Thank you for your photo. Just looking at the profile of your R breast, seems to me that everything is alright.  I don't think you have the signs of "bottoming".  The most important thing is that you are happy with your result.  The scars are visible only when you raise your hands above your head, which is normal.  I cannot see any significant asymmetry which would require further surgery.   You have an elongated chest so naturally your breasts will be positioned a bit lower.  I think your surgeon did a nice job actually,  all the best!

Vladimir Milovic, MD, FRACS
Sydney Plastic Surgeon
4.8 out of 5 stars 19 reviews

Bottom dropping after breast implants.

Hello and thanks for posting your photos and concerns. This does not look like bottoming of the breasts. I also don't see how your scar has travel into the breast except when you raise your hands, which is normal in many cases. If you're happy with your breast result then I think that is the most important factor to consider! You have a pretty result and your breasts do look natural. Enjoy! Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 201 reviews

Bottoming out Breast Implants?

I do not see any obvious bottoming out on these views. Arms up position will always pull up the breast skin, and with it the scar. The scar position looks to be in the fold in all the other views. The asymmetry though present is rather minimal.

I agree with you that this is a  nice outcome. All the best. 


Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.