5 weeks post op, Is my Left Breast Bottoming Out? (photo)

I had implants 5 weeks ago (350 HP saline filled to 375 and 360) One is dropping too low. Is it bottoming out? I'm also feeling like they are too small and I'm noticing more rippling in the past few days. Is it possible to increase the size with silicone implants and also fix the asymmetry? If so, what kind of procedure would be recommended? When is an operation possible? Can I increase to more than 100 cc's?

Doctor Answers 7

Revisional breast surgery probably should not be performed until healing is complete.

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Five weeks is much too early to consider revisional surgery. The modest asymmetry may improve with time. The rippling your discussing probably could've been avoided had silicone gel implants been used. Going with a bigger size is no problem. I would wait at least six months before making a final decision about revisional surgery.

Saline Implants

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I agree with you that it looks like your right implant may be bottoming out - You can do all the things that you want - close the right lower capsule, change to silicone (for the rippling) and go up in size (I think you can go however many cc's up that you want to) at the same operation.  The recovery time will be minimal (much easier than your original operation).  I would wait 3 months from your first surgery - just to allow that little bit of swelling and implant movement to settle down before you change things.  Overall you are doing great - hang in there and good luck!  K. Roxanne Grawe, MD Columbus Plastic Surgeon

Early asymmetry and bottoming out questions

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You are very early in your recovery period and it is easy to be anxious about your final result.  With your body type and lack of breast tissue to support the implant I would suggest against going with a larger sized implant.  This will only accelerate the bottoming out problem.  If your reach the 3 - 6 month period and there are still some asymmetries then would be the time to reassess.  You may need a fold suture or inferior capsulopexy for support of the inferior pole of the breast.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Wait longer before revision

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Your breast and implnat pocket will continue to change over the next several months, and you should wait before you decide just how to revise. The skin envelope is different right to left, and a larger implant can improve the symmetry. If one fold is slightly low a larger implant might center the implant and correct the projection. You look as though you need more volume on the 'higher' side for symmetry, though again time will tell.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Implant malposition can be addressed with Strattice

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You do have some IMF fold asymmetry pre-op - right fold is lower than left side. Your RIGHT breast implant appears to be bottoming out somewhat. Perhaps a consequence of using a fairly large implant relative to your small chest width. This problem could be addressed by DOWNSIZING your implants, creating a new infra-mammary fold on the right side and then reinforcing the repair with Strattice.

Hard to tell

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It is hard to tell from the picture if your right breast implant is going to continue to drop.  Time will be the only way of knowing for sure.  It may not be "bottoming" but rather placed lower as in your preop photo this breast started much lower.  As far as rippling goes with saline implants and going to larger implants you will most likely have more not less rippling so need to discuss this with your surgeon and consider silicone implants as an option as the ripple less.  Regardless at 5 weeks you need to let things heal before doing anything.  I would highly suggest discussing your concerns with your surgeon so that you can keep an eye on these issues.  Best of luck!

Evan Sorokin, MD
Cherry Hill Plastic Surgeon
4.8 out of 5 stars 77 reviews

Bottoming Out after Breast Augmentation?

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Thank you for the question and pictures. The breast implant positioning concerns that you have are visible in the photographs you have posted.  It is probable, given that you are only 5 weeks out of surgery, that additional changes will occur over the course of the next several weeks/months. Therefore, best to evaluate the end results of the procedure performed a few months from now.

 If the breast implant position problem remains a concern, capsulorraphy techniques (internal suture repair of the breast implant pockets) may be indicated. This involves removal of a segment of breast implant capsule among the inferior/lower aspect of the left breast implant pocket. The two edges of  capsule tissue are sutured to one another. This procedure reduces the size of the implant pocket and prevents the descent  of the implants, keeping the breast implants in better position on the chest wall and keeping the nipple/areola complexes  better centered on each breast mound.

You may find the attached link, discussing breast  implant displacement concerns, helpful to you.

 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.