I had revision surgery to fix bottomed out implants. Have they bottomed out again? How can this be fixed? (Photos)

Question

I originally had a breast lift with implants over a year ago. 3 months later they started to bottom out. I had revision surgery done to fix this and i fear it’s happening again. Are they bottoming out? Is there anything i can do to stop it bottoming out more?

Karl William Schwarz, MD · Answer

It does look like the implant is moving down and it makes your nipples start to move up. You naturally have a wider breast and I have found over the years that patients with wider breasts are more challenging for implants and have a much higher rate of re-drooping.

When I suspect someone is going to be what I call a "rapid re-drooper" which also includes descent of the implant I plan on doing a revision at 12 months to get rid of the redundant skin and tissue and sometimes it is required more than once.

I would advise you to wait until you have experienced most of the re-drooping (which takes about 12 months) before going back to the operating room for a revision. I tell patients to give it a year so that we can then remove all of that weak skin and tissue. I have found that revising it too soon doesn't stop the process and you have to do it again anyway so it makes more sense to me to wait until most of the re-drooping has happened and then remove all of this skin and tissue at once.

I also use mesh or Strattice on all of these patients from the beginning to help support the implant.

Benjamin Baker, BMBS MBA FRCS(Plast) · Answer

Hi, thanks for your question. Yes, it does look like your implants may again be bottoming out. You can reduce the risk of this occurring by wearing a supportive bra during the day and at night. Revision surgery could be considered but would not be straightforward. You could consider downsizing your implants, having the implants removed all together (and consider fat transfer to augment volume), using a mesh as an ‘internal bra’ to support the implants, or a combination of these techniques.

Camille Cash, MD · Answer

It does appear that your implants are bottoming out.  This can be seen by the nipples pointing upwards and the inframammary fold moving forward.  Correction would include another revision.  To prevent it from occurring again you can consider smaller implants and/or adding bioabsorbable mesh to support  your breast tissue.  I've included a video I hope you find helpful.

Daniel Barrett, MD · Answer

Dear melinaz17,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ira H. Rex lll, MD · Answer

From your photographs, it seems that the implants and breast tissue are in relatively good position and you have a very nice result.  If your result is stable at this point, you may have many years of good breast aesthetics.

I had revision surgery to fix bottomed out implants. Have they bottomed out again? How can this be fixed? (Photos)

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I had revision surgery to fix bottomed out implants. Have they bottomed out again? How can this be fixed? (Photos)

Answers (8)

Answer: Bottoming out

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Recommended reading

Everything you need to know about Breast Lift with Implants

Our mission is to create a world where every investment in modern beauty is Worth It.