Early signs of bottoming out? (Photo)

Question

550cc silicone implants. 3 months post-op. Had my last follow-up appt. & talked to my doc about my concerns. His answer was to just wear a good supportive bra. I know there's no way to predict the future but does this look like early signs of bottoming out? How soon can I have surgery to correct it, if so? I would rather it not get worse. There's almost a constant dull pain at the incision site (crease) on that side as well.

Dhaval M. Patel, MD · Answer

Thank you for your photos and question. You may have a slight bottoming out on left breast side based on your photos. However, it's too early and difficult to predict the final result. I agree with your plastic surgeon about wearing a supportive bra to help avoid future problems. Furthermore, your capsule (scar tissue) will continue to develop and improve over next few months. That may aid in more support in that area over time. It is best to discuss this matter with your plastic surgeon again and keep a close eye on the matter. Good luck.

Demetrio J. Aguila III, MD, FACS · Answer

Thank you for your question, and for the photos.Bottoming out is a very real concern for many women after breast augmentation.  This is the term that's used to describe when a disproportionate proportion of the breast mass is below the nipple line.  This can occur after breast augmentation, breast reduction, breast lift, or even in the absence of any breast surgery.Having said that, your photos do not suggest that you're bottoming out - you have had a wonderful result, and you and your surgeon should be proud.  I agree with your surgeon that you should always wear a supportive bra - especially during vigorous exercise.  550cc implants are a significant amount of weight, and failing to wear a good bra will accelerate the effect that gravity will have on the breasts, and eventually lead to ptosis, or drooping, of the breasts.Best wishes.

Florence Mussat, MD · Answer

Hi There,you look very good ! I do not think this is bottoming out, you can relax.now, if 550 cc silicone gel, it is about 3 lbs to carry on your chest, so your surgeon is right, you do want to wear a good supportive bra, especially when jogging.enjoy !Florence Mussat

Steven Wallach, MD · Answer

Based upon the photos, it does not look like you have bottoming out. If you have discomfort for whatever reason, you should see your surgeon to be properly evaluated.

Mark P. Solomon, MD · Answer

Your photos show a nice result.  It is difficult to know how much your surgeon had to lower your fold, but you should trust your surgeon to manage your care.  I advise my patients to see me at intervals for the first year after surgery.  That allows me to monitor their progress and look for issues such as bottoming out.  Assuming your weight stays stable, your result at one year should be stable.  I counsel my patients that revision surgery is not generally performed for at least 6 months and preferably 12 months after surgery.

William H. Huffaker, MD (retired) · Answer

It really doesn't appear like you have bottoming out. Your nipples point straight ahead.  With bottoming out, normally the nipples point slightly upwards.Subglandular implants and dual plane implants are more likely to bottom out than submuscularly placed implants.Many times when there is actual bottoming out, elevation of the inframammary crease will repair it.This pushes the implant upwards.

Early signs of bottoming out? (Photo)

Answers (6)

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