What does bottoming out feel like? Can you tell?

Question

What does bottoming out feel like? What causes it- heavy implants or surgical technique? Are girls with breast lifts more prone to it? Is it a problem that usually recurs? How come some girls can manage xl implants with no issue? How can I avoid this? Lastly does not wearing a bra with implants (sometimes) cause this?

William J. Koenig, MD (retired) · Answer

Lots of questions here so here goes:Bottoming out doesn't "feel" like anything, it is a condition where the breast implant drops down on the chest wall below it's natural fold.It can be caused by large implants and surgical technique.It can recur if nothing different is done at the second operation.  Changes that can be made are smaller implants, support of the lower pole with a material like SERI, changing pocket position, reinforcing the inferior fold with sutures.Some patients have strong tissues and  well positioned folds and this almost never happens in these cases.It can be avoided if you have normal anatomy and fold position and choose a reasonable size implant.Wearing a bra is important especially with large implants but I have found that not wearing a bra leads to a heavy lower pole  with thinning of the skin not necessarily bottoming out.Hope this helps.

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