My breast implants have "bottomed out" am I at risk? (Photos)

Good morning!I recommend you go back to your original surgeon and say- hey, I have bottoming out, what's the plan to fix it?"Most PS want their patients to be happy and want their work to show off their talents, so perhaps they will do it for just the cost of the OR? Never hurts to ask!

I am sorry to hear about the  problem you are experiencing.  Unfortunately,  besides the use of supportive bras to help with the discomfort,  surgical intervention (capsulorraphy) surgery is the only option to improve your outcome. Some general thoughts may be helpful to you:Patients in your situation often 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. 
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).
 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. Associated issues with positioning of nipple/areola complexes and visibility of the inframmammary fold scars should improve with this operation.
 I hope this helps.

In my experience the following is needed to correct this issue: 
During your preoperative evaluation, standard measurements are taken from your sternal notch to your nipple, from your bra line to your nipple, the distance of your cleavage and the width of your entire breasts After determining which one of these measurements are excessive, then a plan is formulated. If the distance from your nipple to your bra line is too great (greater than 7 cm) you may be "bottoming out" and you will need a correction that seeks to support the base of the implant (like a hammock) If the width of the breast is too large (when the implant is shifted from side to side) while laying flat AND the implant is extending into the armpit, then you will need sutures on the side of the implant so that it does not fall and rest on your arms  If the distance from the notch of your sternum to the nipple is too great (I use 21cm approximately) then you actually may benefit from a breast lift in addition to other corrections. If you have a lot of "chest" and the implants are lying very low then you can reposition the current capsule higher on the chest wall. 
Take a look a the link that I provided and it should help you think about what you want your next step to be.  A Board Certified Plastic Surgeon is a must. 
I hope this helps 
Dr. Dillon