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!
March 27, 2020
Answer: Dual Plane Breast augmentation Hello Jubilant2138, I favor Dual-Plane over Partial Submuscular (under the muscle) breast augmentation, because Dual-Plane placement allows for a more natural appearance while keeping the benefits of having the muscle cover the implant. On the other hand, under the muscle implant placement is typically more painful, have a significant risk of bottoming out of the breast, and it’s associated with a longer period of recovery, and more post-operative discomfort. Bottoming out is a complication that occurs when the implant rides too low in the breast tissue, causing the nipple to point upwards. Correction for bottoming out involves breast augmentation revision surgery that recreates the pockets within the breast that holds the implants. Patients with poor skin elasticity are most at risk for this problem, which is often accompanied by rippling. Placement of excessively large implants also significantly increases the risk of bottoming out. I would recommend consulting with a board-certified and experienced plastic surgeon to assess your candidacy for breast augmentation and discuss your specific concerns. With appreciation, Dr. De La Cruz.
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March 27, 2020
Answer: Dual Plane Breast augmentation Hello Jubilant2138, I favor Dual-Plane over Partial Submuscular (under the muscle) breast augmentation, because Dual-Plane placement allows for a more natural appearance while keeping the benefits of having the muscle cover the implant. On the other hand, under the muscle implant placement is typically more painful, have a significant risk of bottoming out of the breast, and it’s associated with a longer period of recovery, and more post-operative discomfort. Bottoming out is a complication that occurs when the implant rides too low in the breast tissue, causing the nipple to point upwards. Correction for bottoming out involves breast augmentation revision surgery that recreates the pockets within the breast that holds the implants. Patients with poor skin elasticity are most at risk for this problem, which is often accompanied by rippling. Placement of excessively large implants also significantly increases the risk of bottoming out. I would recommend consulting with a board-certified and experienced plastic surgeon to assess your candidacy for breast augmentation and discuss your specific concerns. With appreciation, Dr. De La Cruz.
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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.
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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
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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