Am I bottoming out at 4 months post-op? (Photos)

Question

I am about 4 months post op and my left breast sticks out to the side a lot more and i also have this indentation in my cleavage. It’s also noticeably bigger than my right. I’ve reached out to my surgeons office a few times now and I’m still waiting to hear back. What are my options? Feeling pretty discouraged I’ve been trying to be patient. I started wearing a wired bra 24-7 right before i hit the 3 month mark per my surgeons offices instructions.

Lawrence Iteld, MD · Answer

Based on you photos, it appears that one side is a bit lower than the other, but it is difficult to tell if this is due to bottoming out or if it is normal asymmetry of your folds.You are doing the right thing by trying to contact your surgeon. If they are not getting back to you, I recommend that you see another plastic surgeon for an in-person evaluation

Daniel Barrett, MD · Answer

Dear christinaallie,bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Unfortunately without an in-person examination it is difficult to confirm your suspicions of bottoming out but I can appreciate the differences in your right and left breasts. Unfortunately after 4 months it is unlikely that conservative treatment such as a bra will correct the issue and a revision may be required.  I would recommend discussing with your surgeon, or seek a second opinion, as to what treatment options exist.  Best wishes.

Tom J. Pousti, MD · Answer

I am sorry to hear about/see the problems you are having after breast augmentation surgery. I think your concerns are appropriate; one of your breast implants does seem to sit low on your chest wall, consistent with breast implant displacement ("bottoming out”).
Generally, signs of breast implant bottoming out include: 
1. Breast implant "sits" too low on the chest wall.
2.  Excessive palpability or visibility of the breast implant along the lower breast pole.
3.  Nipple/areola complex seems to be sitting relatively high, because the breast implants have settled too low. 
4. Discomfort along the lower breast pole (secondary to pressure from the underlying implant).
5. Relative paucity of upper pole breast implant volume compared to lower pole volume.
6. Increased visibility of a infra mammary fold scar (higher on the breast mound).
I think that you may benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). Sometimes, depending mainly on the patient's history and physical examination, I will also use additional supportive materials such as acellular dermal matrix or biosynthetic mesh. This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly.  Any associated issues with positioning of nipple/areola complexes and any visibility of the inframmammary fold scars should improve with this operation.
 I hope this  helps.

Christopher V. Pelletiere, MD · Answer

Based on your pictures, it does appear that you have a degree of symmetry more than would be expected.  Without an examination it is hard to say what is going on, but it certainly does appear that the one breast appears wider and fuller in the inferior aspect versus the other side.  You are far enough out now that I would not expect any more changes with regards to swelling going down, etc.  I would go in for a follow up with your board certified plastic surgeon or have a second opinion consultation if needed with another surgeon.  I hope this helps.

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Am I bottoming out at 4 months post-op? (Photos)

Answers (9)

Answer: Am I bottoming out at 4 months post-op?

Answer: Am I bottoming out at 4 months post-op?

Answer: Breast Implant Revision?

Answer: Breast Implant Revision?

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Our mission is to create a world where every investment in modern beauty is Worth It.