What to do about bottomed out breasts? (Photo)

I am about 3 months post-op. 520cc unders. I clearly see my breasts have bottomed out, but I'm not sure what to do. I feel I chose the wrong doctor. He has not seen me since the operation and communication seems to be difficult. What should I do?

Doctor Answers 4

What to do about bottomed out breasts?

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I am sorry to hear about/see the problems you are having after breast augmentation 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”).
It is possible that you are feeling the implants significantly along the lower poles of the breasts. Patients in your situation sometimes complain of discomfort in the area of implant malposition. 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 (dedicated to corrective surgery for bottoming out concerns), helps.


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If you think you have bottomed out, then you need to see your surgeon or another for evaluation.  Surgery would be indicated to repair bottoming out.`

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Redo breasts augmentation

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Dear Dmg,   Thanks for submitting your picture and sorry for your problems. It would have been very helpful to see front and side view pictures in a vertical position (your is horizontal).                                                                                                 From observing your picture, you appear to have down ward displacement of the implants( bottom out ), flat upper pole, wide cleavage with lateral displacement of  the left implant.                                                                                 Most likely you will need revision surgery with superior and medial capsulotomy (scar release) and inferior capsulorrhaphy (internal bra) with possibly left  lateral capsulorrhaphy. However, at this stage it is probably worth trying to help the situation for the next 3 months, by doing implants displacement massage and wearing  a bra with a wire 24/7.                                                                                                                                                                            If after that period of time, there is no improvement and you do not get a satisfying response from your surgeon, consult with other experienced board certified plastic surgeons who have lots of experience with redo breasts augmentation in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery , to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking. Also, check the reviews on 'RealSelf' for ratings and positive experience reports.                                                                                                                                                                                                           Best of luck,                                                                                                                                                                                         Dr Widder                          

What to do about bottomed out breasts?

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Thank you for your question and photograph.  When implants bottom out the typical correction is revision surgery to suture the lower breast implant pocket to prevent the migration of the implant downward.  If you are having communication difficulties with your surgeon you may wish to consider a second opinion from an ASPS board certified surgeon.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 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.