4 months post augmentation. 265 cc silicone sub muscular, does this look normal? (photos)

4 months post augmentation. 265 cc silicone sub muscular. The left breast has no fold/crease, no articulated cleavage (feels flat to touch) and a indented line along my pectoral muscle. My surgeon says he would like to just do fat grafting to fill line... Im very disppointed and know this is not how it should look. The right side is perfect.

Doctor Answers 8

Bottoming out of your breast implant

It appears that your implant has bottomed out. This means that the implant has descended below the breast fold. This has blunted the crease and caused the nipple to point upward, as compared to the other side that you like. Fat grafting may help to soften the edge of the implant and decrease visibility and palpability, however, it will do nothing to correct the breast crease. This will require a revision and suture repair of the fold. You should expect a nice result as long as you select a surgeon experienced in breast augmentation revision.

New York Plastic Surgeon
4.9 out of 5 stars 326 reviews

4 months post BA one sided issue

It looks like the fold under the breast settled more on one side than the other - they are not even. If the photo is flipped then that would correspond with your left side. (It looks like the right side if we are facing you as you stand right now as published). The implant can be reset by opening the incisionand elevating the fold. This would push the implant up into your upper chest and fill the crease that is present. Try simulating this by pushing the implant up. That would take care of the need for fat grafting.

Best of luck.

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 53 reviews

Concerns after breast augmentation surgery...

I am sorry to hear about your concerns after breast augmentation surgery. Based on your photographs, I think that part of the breast asymmetry concerns has to do with differential breast implant settling. In other words, one of your breast implants seems to be sitting lower on your chest wall compared to the other.  Consistent with this breast implant displacement concern is that the nipple/areola complex on that side sits higher on the breast mound.  It is possible that revisionary breast surgery, involving capsulorraphy surgery, will improve breast symmetry significantly.

 I hope this, and the attached link helps, Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

About Breast Implants "Bottoming Out"

"Bottoming Out" is the term given to implant #displacement, where the implant drops down below the existing inframammary fold; the natural crease beneath your breast. This may occur when the fold has been released excessively during surgery or may be due to factors of the patient’s collagen and tissue integrity. The implants then sit very low on the chest with a lack of internal support for the implant itself.

Correction usually involves #restoring the crease beneath your breast to it's normal position with internal reconstruction of the capsule around the implant (#capsulorrhaphy). Sometimes a biologic fabric (Acellular Dermal Matrix or #ADM) can be used to attach to the breast tissue internally while supporting the implant.
This corrects the placement of the implant, redefines the breast shape, and also refines the internal fold. Your board-certified plastic surgeon will discuss which approach is best suitable for you based your current implants.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Bottoming Out


The implant appears to have fallen past the crease on one side. This is referred to as "bottoming out" and will need surgical correction. Talk with your Plastic Surgeon about a plan.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Breast asymmetry

Everyone's anatomy is different and for minor asymmetries or lack of soft tissue coverage, fat injection  is a reasonable.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

S/p breast augmentation

It appears that the right breast implant has dropped more than the left one. A comparison of your before and after photos would be helpful. Re creating the inframammary crease on your right breast is something which may need to be considered. Discuss with your operating surgeon at your next visit.

Paul M. Parker, MD, FACS
Paramus Plastic Surgeon
5.0 out of 5 stars 35 reviews

Asymmetry after breast augmentation

I think you mean your right breast is the one you are unhappy with (you say left but that is left in the picture, right side on your actual body)  It's important to look at before photos to compare what has changed since your surgery.  There may be some clues as to why things have healed differently on the right breast.  Stay in touch with your surgeon as things will also continue to change over the next few months.

John McFate, MD
Austin Plastic Surgeon
5.0 out of 5 stars 9 reviews

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.