Seeing so many reviews on this site, bottoming out seems to be one of the top complications that occur. Putting patients and their behavior aside, what strategies do you use to minimize risk of bottoming out? Do doctors need to compromise worse levels of animation deformity (or anything else) in order to create a tight pocket for the implant that won't cause it to fall too low? Thank you!
Answer: Breast augmentation Bottoming out refers to stretching of the lower pole breast skin/tissue increasing the nipple to IMF distance. In my opinion, the transaxillary approach where the breast crease is lowered can weaken the inframammary breast crease and contribute to this problem. Overly large implants will place more stress on the lower pole and also contribute to bottoming out. Finally, a patient tissue quality/elasticity is important in maintaining. In cases where my patient may have poor skin quality I generally will place internal suture to support the inframammary breast crease. In addition, the inframammary breast crease approach and choosing an appropriate but more conservative implant size will decrease bottoming out.
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Answer: Breast augmentation Bottoming out refers to stretching of the lower pole breast skin/tissue increasing the nipple to IMF distance. In my opinion, the transaxillary approach where the breast crease is lowered can weaken the inframammary breast crease and contribute to this problem. Overly large implants will place more stress on the lower pole and also contribute to bottoming out. Finally, a patient tissue quality/elasticity is important in maintaining. In cases where my patient may have poor skin quality I generally will place internal suture to support the inframammary breast crease. In addition, the inframammary breast crease approach and choosing an appropriate but more conservative implant size will decrease bottoming out.
Helpful 2 people found this helpful
Answer: What strategies do you as surgeons use to avoid bottoming out of implants? Hello and thank you for your question and sharing your photos. Successful outcomes after breast augmentation needs careful surgical planning, implant selection, meticulous surgical technique, and good post op care. I would avoid using excessively large implants as they tend to stretch out skin envelope and cause bottoming out. I would seek consultation with a board-certified plastic surgeon
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Answer: What strategies do you as surgeons use to avoid bottoming out of implants? Hello and thank you for your question and sharing your photos. Successful outcomes after breast augmentation needs careful surgical planning, implant selection, meticulous surgical technique, and good post op care. I would avoid using excessively large implants as they tend to stretch out skin envelope and cause bottoming out. I would seek consultation with a board-certified plastic surgeon
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March 30, 2020
Answer: What strategies do you as surgeons use to avoid bottoming out of implants? Surgical expertise and good judgment are the most important factors. You cannot change your intrinsic tissue quality. Surgical technique for breast augmentation should allow for conservative muscle release but preservation of all retaining fibers inferior to that. Your PS should help you decide on an implant size to prevent it from being too big and heavy for your skin and breast tissue. The dissection of the pocket for the beast implant must fit appropriately and implants should be placed in the dual plane.
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March 30, 2020
Answer: What strategies do you as surgeons use to avoid bottoming out of implants? Surgical expertise and good judgment are the most important factors. You cannot change your intrinsic tissue quality. Surgical technique for breast augmentation should allow for conservative muscle release but preservation of all retaining fibers inferior to that. Your PS should help you decide on an implant size to prevent it from being too big and heavy for your skin and breast tissue. The dissection of the pocket for the beast implant must fit appropriately and implants should be placed in the dual plane.
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March 27, 2020
Answer: Dual Plane Breast augmentation Hello Jubilant2138,
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March 27, 2020
Answer: Dual Plane Breast augmentation Hello Jubilant2138,
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March 27, 2020
Answer: What strategies do you as surgeons use to avoid bottoming out of implants? Thank you for sharing your question. Using precise surgical technique and a well-sized implant relative to a patient's natural anatomy helps to limit the risk of bottoming out. Hope this helps.
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March 27, 2020
Answer: What strategies do you as surgeons use to avoid bottoming out of implants? Thank you for sharing your question. Using precise surgical technique and a well-sized implant relative to a patient's natural anatomy helps to limit the risk of bottoming out. Hope this helps.
Helpful
March 26, 2020
Answer: Probably experience most important! That’s a great question… In almost all women, the inframammary fold sits a little too high for most implants to provide a balanced breast (45% of the implant/volume above the nipple and 55% below) and an almost all cases surgeons need to adjust that information refilled. My feeling and experience is anything that weakens that area too much could allow the implant to slip too low. Here is where I disagree with Dr. Burns. Having done the axillary approach for over 20 years now, I believe it has LESS of a tendency because there is no incision in the inframammary fold. The dermal fascial attachments are not weakened by the incision and the dissection, and I think it provides more support. therefore I think the axillary approach or periareolar has the lower chance of bottoming out but honestly, it all comes down to surgeon experience. Great results can be obtained with any incision!! I also think it helps if patients can get into a snug underwire bra once their implants settle where they like them. It may help to wear that for the first 6 to 8 weeks or so just to “lock them in place“. My favorite is the Victoria’s Secret Knockout bra
Helpful 1 person found this helpful
March 26, 2020
Answer: Probably experience most important! That’s a great question… In almost all women, the inframammary fold sits a little too high for most implants to provide a balanced breast (45% of the implant/volume above the nipple and 55% below) and an almost all cases surgeons need to adjust that information refilled. My feeling and experience is anything that weakens that area too much could allow the implant to slip too low. Here is where I disagree with Dr. Burns. Having done the axillary approach for over 20 years now, I believe it has LESS of a tendency because there is no incision in the inframammary fold. The dermal fascial attachments are not weakened by the incision and the dissection, and I think it provides more support. therefore I think the axillary approach or periareolar has the lower chance of bottoming out but honestly, it all comes down to surgeon experience. Great results can be obtained with any incision!! I also think it helps if patients can get into a snug underwire bra once their implants settle where they like them. It may help to wear that for the first 6 to 8 weeks or so just to “lock them in place“. My favorite is the Victoria’s Secret Knockout bra
Helpful 1 person found this helpful
