How do you correct bottoming out?

Question

I had breast implants 6 months ago. My primary PS said that I'd dropped a little low (1-2cm) in my left implant but was in the normal range. I sought another opinion. The 2nd PS said that I'd bottomed out, with a touch of lateral displacement. Both PS said this was from weak tissue. He said that he could go in under local anesthesia, remove some skin and place stitches inside my pocket to support the implant. Is this routine? Do I need an internal bra? How do you permanently fix this?

Steven Wallach, MD · Answer

Bottoming out may require the capsule to be tightened and a mastopexy of the surrounding breast tissue. It is difficult to say without an exam.

Curtis Wong, MD · Answer

isn't that straightforward.  Your tissue must be examined and the size of the implant considered and if too large, downsizing could be reality.  Your own motivations must be reviewed and the different techniques bring with it different costs.  Then you must choose what is best for you.When a surgeon tells you its 'normal' and you disagree, simply ask your surgeon if he/she would be happy with you showing your friends your results or posting your results on site such as this.

Peter E. Johnson, MD · Answer

It sounds like two surgeons disagree. It is important how you feel about the result and if you think the breast is low an needs correction. Bottoming out is usually repaired by closing the pocket with a capsule suture and resetting the breast fold. For a few a support material might be needed such as Strattice. The "remove some skin" doesn't sound right and the local anesthesia might limit the ability to do the repair correctly. Few things are "routine" so choose your surgeon carefully.

Michele Koo, MD, FACS · Answer

Bottoming out can occur from the tissue stretching or the implant slipping out of the intended pocket. The solution depends on the problem but can be corrected with skin removal, placement of a silk sheet or artificial skin, or simply replacing the implant in a higher position with placement of a few sutures. It usually does require another procedure. Whether you return to the operating room or have it performed in the office is dependent on your surgeon. It should be able to be corrected.Michele Koo, MD, FACS

Jason Brett Lichten, MD · Answer

When the breast implants sit too low on your chest, you may need to consider a second surgery to correct this problem.  This may involve surgery on the breast implant capsule, the lower breast tissue or the skin of the breast.  Sometimes you can use an "internal bra" with a product like Strattice for internal support.  You should have a discussion with a board certified plastic surgeon (whether your original surgeon or a second opinion) about what the different pros and cons of the various options are to figure out what is best for you.Good luck and feel free to contact me if you have any more questions.

Steven M. Camp, MD · Answer

Bottoming out can occur after breast implant surgery, and correction depends on the problem.  Many times the implants can be repositioned with repair of the breast capsule if the problem is minor.  In more significant cases a tissue support matrix like alloderm may be needed to support the implant in the proper position.

Melek Kayser, MD (retired) · Answer

A number of reasons can cause this - too large of an implant, overexpansion the original fold or excess lower pole skin before surgery that may have needed a lift. In any case, correction can be done in many ways depending on the severity icnluding internal suturing or using the breast capsule to reinforce the correction. Even the use of skin substitue called acellular dermal matrix (ADM) is oftern helpful but is expensive. I hope this helps and have a wonderful day! Dr. Kayser

How do you correct bottoming out?

Answers (7)

More Breast Implants Questions

Can saline implants give me a natural look and feel?

How much will the breast shrink after getting implants?

I had McGhan style 468 implants on March 29 2002.Never had any problems with them except being very hard.

17 years PO, I think one implant is leaking. What should I do?

What size & type of implants are right for me?

WE SEND PRETTY
EMAILS