Shape of new set 560 cc. Could I be bottoming out? What does that even mean? (Photo)

I'm concerned about the shape of my boobs have came to be I'm about 5 month post op, I love the way they look with a sports bra on but when I look in the mirror with no bra they are shaped funny looking both sides look so different compared to the other

Doctor Answers 7

Asymmetry after BAM

It is very difficult with your picture and history to determine what is happening. We would need more clinical front and side views. We would also need the preoperative pictures. I would recommend resubmitting your question with the above pictures. Better yet, discuss with your PS!Best of luck!

Shape of new set 560 cc. Could I be bottoming out? What does that even mean?

Hello dear, thanks for your question and provided information as well.. The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but  also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue… Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 358 reviews

Breast asymmetry

Thanks for your inquiry, but without a before picture and maybe better pictures that someone else takes with your arms at your side would be helpful.  Post-operative breast asymmetry often is due to pre-operative asymmetry.  Ask your surgeon to discuss.  

Bottoming out & Difference in Breasts 5 month Post-op?

Thank you for your question and photo.

You are 5 months post-surgery, and you may very well be seeing your final results. However, please note that some patients may achieve final results after a full 6 months and a smaller proportion may get final results after 12 months.

According to the photo, your breasts do not look funny looking, and they have not bottomed out (see description below) but it is hard to tell with just a one-angled perspective. It is best to follow-up with your board-certified plastic surgeon and share your concerns.

With regards to your breasts looking different, nothing can be said as we do not have before surgery photos. If your breasts looked different before surgery, then it is important to appreciate the fact that breast augmentation predictably does only one thing: it makes your breasts larger and does not cause any other major changes such as fixing asymmetry or closing in a large cleavage gap. If you breasts were fairly similar, and are not anymore, then it may be the case that your breasts are healing and adapting to the implants at different rates. As such, there may be visible differences which with time may disappear.

Finally, I provide information about bottoming out, its clinical signs, and surgical correction?

Bottoming out is also known as breast implant displacement and it happens results from the failure of the implant pocket resulting in the breast implant slipping below the natural or surgically lowered inframammary crease overtime.

A pocket can fail when there is loss of internal tissue support at the bottom half of the breast and this may lead to the breast implant to move downward on the chest, gradually lowering the natural bottom (crease fold) of the breast.

Clinical signs will include the implants ending up too low on the chest wall, the nipples will not only tilt upward as the breast implant heads down, but also be positioned higher on the breast mounds. Unfortunately, any inframammary scars from breast augmentation may travel up the lower breast mound. There will be no pain, but you may notice thinning of the skin at the bottom of the breast, which will allow you to more easily feel the breast implant.

An adequately created pocket can prevent this from happening. After surgery, wearing a supportive underwire bra that applies pressure to the fold at the bottom of the breast may help prevent bottoming out.

To correct “bottomed out” breasts, a surgeon would need to secure the implant in an elevated position and then reinforce the implant capsule at the bottom of the breast with a suture technique. There may be a need for Acellular Dermal Matrix, a soft-tissue graft, in the repair. A smaller implant is often advisable, if the original was too large.

Hope this helps!

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 reviews

Concerned about shape of breasts?

Hello and thanks. I do not see your point of concern on the photo posted. The breasts in that photo look attractive and round. I also do not see evidence of bottoming out. Perhaps, it's time to have a follow up with your plastic surgeon about these concerns and to be sure the heavy 560 cc weight isn't stressing your tissues too much. Good luck, Dr. Aldo

Aldo Guerra, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 190 reviews

Shape

Just based on your one photo with clothes still present is difficult to say what is happening. I would suggest going back to your surgeon and discussing any concerns.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Breast augmentation and the issue of bottoming out

Bottoming out means that the implant has settled and sagged way below the inframammary fold.  It is difficult to assess the situation based on one photo, so a personal consultation is required to "review" your case.
Share your concerns with your original PS, or you may consult with another doctor.  Make sure that you only consult board-certified plastic surgeon who performs breast augmentation on a regular basis. 
Good luck and best wishes. 

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.