Bottoming out more common with small/narrow implants?

Dear Lemondrops1010,
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

Multiple factors including the surgeon dissecting to low can be a cause- not a small implant size. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Great question! Risk factors for bottoming out following breast augmentation typically include the following: 1. Thinner lower pole skin from weight loss and aging. 2. Use of heavier (larger implants 3. Use of smooth implants under a very strong thick pectoralis muscle key is that you discuss your concerns with a Plastic Surgeon who is board certified and demonstrates an expertise in Breast Augmentation.
Good luck

I would reassure you that while bottoming out can and does happen, I have never heard / read or experienced it being related to smaller implants. Many actually believe larger implants have a greater likelihood of bottoming out with time, given the heavier weight of the implant and its increased likelihood to descend down the chest wall as a result. Precise surgical technique can prevent bottoming out, particularly ensuring that the inframammary fold (IMF) is not dissected / violated. This fold is a fascial structure that secures the skin to the chest wall muscle fascia and maintains the position of the breast (and implant in this case). Dissolvable mesh is also becoming increasingly more popular in breast augmentation to prevent bottoming out and is commonly placed along the lower edge of the implant to reinforce the IMF and maintain a longer term result.
Hope this helps!

When implants are place behind the pectoralis major muscle, the inferior border attached to the 5th and 6th ribs is usually cut. This results in part of the implant being under the muscle and part of the implant not being under the muscle. When the muscle contracts, the implant is extruded inferiorly and laterally causing bottoming out. This is also dependent on the size, shape and position of the implants. When implants are placed in front of the muscle, the only thing holding up the breast implant is the skin envelope. Large implants are heavier and the skin envelope may not be able to handle the weight of the implants. This is why I always recommend smaller implants and placed submuscular.

Best Wishes,

Gary Horndeski, M.D.

Dear Virginians,
The most common cause of breasts' implants bottoming out is over dissection of the infra mammary crease. This occurs more often with the sub mammary incision approach since it is difficult to be precise with that technique as oppose to the sub areola incision technique. Large implants can be contributing factor to bottoming out since they weigh down on the sub mammary crease and over time can stretch the tissue and slide down bellow the crease. So, the possible bottoming out of 250 cc breasts implants is quite low unless a technical error took place.
Always consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the photo gallery to make sure that the pictures are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.
Best of luck,
Dr Widder
widderplasticsurgery.com

Bottoming out is not the the result of the size of the implant but the technique of insertion and the sagginess of the breasts before putting the implants. Larger implants in a subglandular plane bottom out more because the skin stretches under the implants weight.

Bottoming out is more prevalent in patients with large, heavier implants versus small implants and those with thinner skin. In these cases sometimes bioabsorbable mesh can be used to support the tissues and help prevent bottoming out. It can also be related to surgical technique during augmentation surgery.

Bottoming out is usually caused by an over dissection and lowering of the pocket, or too heavy of an implant on this lower breast tissue which thins and pushes down more.

Bottoming out, a complication where breast implants descend below the natural breast crease, can occur with any size or shape of implants, regardless of whether they are small or narrow. However, certain factors may increase the risk of bottoming out, including:1. Implant size: While bottoming out can occur with any implant size, larger implants may exert more downward pressure on the tissues, increasing the risk of bottoming out, especially if the natural breast tissue is insufficient to support the implants adequately.2. Implant placement: Implants placed in the subglandular position (above the muscle) may have less support from surrounding tissues compared to implants placed in the submuscular or dual-plane position. Subglandular placement may increase the risk of bottoming out, regardless of implant size.3. Tissue quality: The quality and quantity of natural breast tissue play a significant role in supporting breast implants. Patients with thin or weak breast tissues may be at higher risk of bottoming out, regardless of implant size.4. Surgical technique: The surgical technique used to create the implant pocket and secure the implants can influence the risk of bottoming out. Improper pocket creation or inadequate fixation of the implants may increase the likelihood of bottoming out occurring.5. Body anatomy: Individual variations in chest wall anatomy, breast shape, and tissue elasticity can also affect the risk of bottoming out.While small or narrow implants may theoretically exert less pressure on the tissues compared to larger implants, other factors such as implant placement and tissue quality play a more significant role in determining the risk of bottoming out. It's essential for patients to discuss their goals, concerns, and implant options with a board-certified plastic surgeon who can provide recommendations based on their individual anatomy and aesthetic preferences.