What will happen if I don't fix my implants that have bottomed out? (photos)

Question

Hello, I am 11 months post-op and I have noticed that my implants have bottomed out. What will happen if this is not fixed with a revision? Also, can I prevent the implant from dropping any lower by wearing a supportive bra?

Randal Haworth, MD, FACS · Answer

When breast implants bottom out, it means they have descended below the natural inframammary fold, resulting in an unnatural appearance. If left untreated, it's possible for the condition to worsen over time. It's best to consult with a qualified plastic surgeon as soon as possible.

Wearing a supportive bra may help provide temporary support and prevent further sagging, but it's unlikely to correct the issue on its own. Surgical intervention, such as a revision surgery, is often necessary to reposition the implants and restore the desired aesthetic outcome.

I hope this helps,
Best of luck !

Daniel Barrett, MD · Answer

Dear helenexo,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Wess Cohen, MD · Answer

Thank you for your question. Your implants have bottomed out. Wearing a supportive bra can help slow down the process, however, this will continue to get worse over time. Revision surgery could include internal sutures, and also an internal bra to provide support and longer lasting results. Good luck.

James Knoetgen, III, MD · Answer

If you don’t address breast implants that have “bottomed out”, several potential issues can arise:1. Aesthetic Concerns: Bottoming out can result in a distorted appearance, where the implants appear too low on the chest. This can lead to an unnatural look and dissatisfaction with the results.2. Discomfort: Bottoming out can cause discomfort or pain, as the implants may press against the chest wall or create tension on the surrounding tissues.3. Sagging: The breast tissue may sag more than desired due to the downward migration of the implants.4. Stretching of Tissues: Over time, the weight of the implants can stretch the breast tissues and skin, potentially causing irreversible damage.5. Complications: Bottoming out can increase the risk of other complications, such as rippling, wrinkling, or implant visibility. 6. Implant Exposure: In severe cases, the implants might become exposed or protrude through the skin, which would require immediate medical attention.It’s essential to consult with a board-certified plastic surgeon to discuss your specific situation and options for addressing bottoming out, which may include implant revision surgery to reposition or replace the implants. Ignoring the issue can lead to long-term dissatisfaction and potential health concerns.

Connie Hiers, MD, FACS · Answer

You can help prevent more bottoming out by wearing a good supporting bra with underwire.  When the time comes to exchange them, you may need an internal bra of mesh and go down in size. Your tissue is not supporting the weight of these implants.

Camille Cash, MD · Answer

You are correct in your statement that your implants have bottomed out.  The best you can hope for is that they will not get any worse, but they certainly could.  This condition can be an indicator that the implants are too large/heavy or that your skin isn't strong enough to support the implants.  The potential solution involves exchange for smaller implants, adding a supportive mesh, or both.  See a board certified plastic surgeon near you to learn more.

Douglas Taranow, DO, FACOS · Answer

You have larger implants and appear to have bottoming out (based on your one photo with arms extended over your head).  The breasts may stop where they are or continue to descend (no one knows for sure).  Using an underwire bra and good supportive garments should slow or stop the downward progression.
Best wishes,
Dr. Taranow

What will happen if I don't fix my implants that have bottomed out? (photos)

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