I'm six months post op, am I bottoming out? (photos)

I'm very concerned I'm bottoming out. I emailed my surgeon 2 months ago, but never got a reply. I'm out of state. My incision line is no longer in the crease of my best but is usually on the lower portion of my breast. I had mentor 325cc silicone implant subpectorally implanted. Now that it's been a full 6 months I'm definitely worried. What do you think?

Doctor Answers 14

Bottoming Out

I can't comment on whether you are bottoming out as this is a determination best made on exam.  I do want to point out the difference between bottoming out and fold malposition.  Bottoming out usually refers to an increase in the distance between the nipple and the inframammary incision but the incision remains in the fold.  Fold malposition, on the other hand, refers to the new fold falling below the inframammary incision.  Its important to make a proper diagnosis as the surgical treatment can be somewhat different. 

Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

Am I Bottomming Out?


Thank you for your question and photos. You are not necessarily bottoming out. If your breasts are settled symmetrically in this position with the incision slightly above the crease, that is ideal, however if your implants seem to be shifting down further as time goes by then you should be seen by your Plastic Surgeon in person. I recommend that you contact them and request a follow up appointment to discuss your results.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

I'm six months post op, am I bottoming out?

I agree that you do not appear to be "bottoming out" from reviewing your photos.  Typically bottoming out refers to implants "drifting" below the fold. Sometimes they can also "fall to the sides" when a patient lays down.  Some of this is normal in all patients and I do not think anything in your photos appears to be abnormal.  I think the "spacing" of the implants really has to do with the shape of the chest wall and the slope of the rib cage. Sometimes when patients lie down, they feel the implants drift a bit to the sides because of gravity, the weight of the implants, and the slope of the chest wall. I personally recommend to my patients to wear a well supported sports bra after surgery at night for the first year.  I believe that helps externally support the breast and keep the implants from drifting. I would ask your plastic surgeon about that.  I hope that helps!

James F. Boynton, MD, FACS
Houston Plastic Surgeon
4.8 out of 5 stars 42 reviews

Am I bottoming out?

From your photos, you do not appear to be bottoming out. Some migration of the incision out of the fold is normal with time, and unless the implant continues to drop you should be fine. However, it is important to examine you and discuss your concerns.  I would keep trying to contact your surgeon.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 95 reviews

Implants settle postoperatively

Hi Cmomma4.  Thank you for sharing photos.  It is difficult to determine without seeing your results immediately after surgery, comparing measurements etc.  There is settling that occurs in everyone that can lead to migration of the scar onto the breast mound. Be sure to wear a supportive bra when exercising and avoid laying on your stomach so that you don't have downward pull on the implants.  Bottoming out that necessitates additional surgery will generally result in loss of upper cleavage/fullness, nipples that are pointing upwards or not centered, the lower curve of the breasts will be much lower with an increase in the distance between the nipple and it, and a scar that is considerably higher on the breast mound/visible from the front.  Have a consultation with an ABPS certified plastic surgeon to review your options.  Best wishes,

Vaishali B. Doolabh, MD, FACS
Jacksonville Plastic Surgeon
4.9 out of 5 stars 33 reviews

Are my implants bottoming out

Without an exam or without being able to look at sequential photos from the time of your surgery until now it is difficult to give a definitive answer.  Although an inframammary incision that migrates up may be an indicator of a bottoming out implant, it may also happen with normal settling of a breast implant.  Overall you appear to have a good result.  Nonetheless, I would convey your concerns to your primary surgeon.  If he or she does not get back to you, it is reasonable to seek out a board certified plastic surgeon in your area for a consultation.

Charles Galanis, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 20 reviews

Bottoming out

It looks like your incision us s not higher but this us normal to done degree. There is tissue relaxation that occurs during the settling process. As long as the bottom of the breast keeps a nice smooth round shape and no double bubble shape you should be fine 
If you don't get a response from your surgeon try to get follow up with a local plastic surgeon 

David R. Alfonso, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 53 reviews

Am I bottoming out.

Bottoming out usually means that the point of projection of the implant is below the nipple. Your implant looks well centered and the result seems to be quite good. 

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Am I bottoming out?

Thanks for your question and photos.
Based on your photos, they do not look like implants are bottoming out.
However, in-person examination is needed to verify it.
Best regards.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

Bottoming out implants

There may be a little motion towards the lower pole in your case, but without sequential photos, it would be hard to tell for sure.  As it is, you have a very nice result, so I would not do anything about it at this point.  Be sure to discuss with your own surgeon about how this applies to you, and whether they have any special concerns in your case.

Reza Momeni, MD FACS
Summit Plastic Surgeon
5.0 out of 5 stars 44 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.