Have my implants bottomed out? (photos)

I had my surgery 1 year and 2 months ago, 300 moderate profile silicone under the muscle, incisions under the breasts. I didn't have much skin tissue to begin with that's why I went with smaller implants. Can you pls tell me if my implants sit too low now ( I don't have upper fullness ) and do I have a case of bottoming out? And how long should I wait to do a revision surgery after the original one? Thank you!

Doctor Answers 16

Bottomed Out Implants

You have a very nice result and I will not consider that your implants have bottomed out. There is a small asymmetry on your sub mammary crease, but that asymmetry was there before the surgery and it is very small.

Are implants bottoming out?

From your photographs, it does not appear to be so.  However, an in person examination would be needed.  The photos show the left implant lower in one front view and the right implant lower in another.  i think this has to do with your shoulder position, with one being higher or lower.  The right breast appeared smaller than the left to start with.  The implants appear a "little" low in the photographs, but this is not a "double bubble" or "bottoming out" appearance.  Larger implants can be placed to give more upper pole fullness at any time of the current implants can be lifted by having your surgeon elevated the inframammary fold. You should consult with your surgeon to discuss your concerns and options.

Todd C. Case, MD
Tucson Plastic Surgeon
5.0 out of 5 stars 54 reviews

Are my implants bottoming out

Thank you so much for your question about your breast augmentation.

Your photos show a nice result.
  • The photos don't show bottoming out.
  • Your breasts were slightly asymmetric before surgery (that is normal)
  • The asymmetry is the same after implants
  • If you aren't happy with the size or asymmetry, talk to your plastic surgeon about a revision and what is involved.

Be sure to see a Board Certified Plastic Surgeon.
Here’s hoping you find this helpful. Have a great day!

Bottom out?

Based on your implant information and photographs you do not appear to have any bottoming out. Your results look great. 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 416 reviews

Bottoming out? timing of revision surgery.

Thank you for your question and pictures.
I think your implants are properly placed. You definitely have more upper pole fullness now compared to your preoperative picture. "Bottoming out" usually refers to implants that sit so low that the nipples are facing the sky. If you are unhappy with the implant position or size, revision surgery can be performed at any time.

I hope this helps.

- Dr. Bryson G. Richards, MD

Bottomed out implants?

You have a very nice result from your breast augmentation. Any revisionary surgery( like capsulorrhaphy) can be done, but carries with it some risk, as well as the possibility of relaxing again to where you are now.  Review options carefully with your surgeon in person.  The upper pole fullness that many crave is most easily achieved with a push up bra (the old Hollywood trick). Best, 

Click on the link below to see bottomed out implants treated with capsulorrhaphy.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 29 reviews

Have my implants bottomed out?

Thank you for the question and pictures. Sometimes, “bottoming out” can be a matter of opinion or preference. In other words, regardless of the semantics used, your breast implants could sit higher on your chest wall allowing for the “upper fullness” that I believe you are trying to achieve. Capsulorraphy surgery will be helpful in this regard. This technique involves suture “repair” of the lower breast implant capsule;  the procedure will serve to prevent movement of the breast implants inferiorly and allow for more breast fullness superiorly. Given that you are 14 months out of the procedure performed, the revisionary breast surgery can be performed at any time. You may find the attached link helpful to you as you learn more about revisionary breast surgery. Best wishes.

Have my implants bottomed out?

You had pre-existing asymmetry prior to breast augmentation and have achieved a great result in my opinion.
Your nipples are in good position and you do not have bottoming out of your implants.  Hope that helps!

Jules Walters, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 45 reviews

Bottoming-out or not?----may be a variant with inferomedial migration due to muscle release


I do not think you have classic bottoming-out, as much as your left breast seems to be moving a little bit further medially than ideal. The only way that can happen is if the lower pole pectoralis muscle attachments were cut at the time of surgery with the release extending up along the lower sternum.  The easiest way to assess that is to stand in front of a mirror with hands on your hips and thumbs toward the back and press medially on your hips to flex the pectoralis muscles. If the muscles have been cut you will see a groove form obliquely across the lower poles of your breasts, extending toward the armpits, and tending to pull the breast tissue upwards and pushing the implants downwards and medially on the left.  If that is the case, repair may prove necessary at some point because the implant or implants may continue to move downward and medially because of lack of muscle support, and due to downward pressure during some pectoralis flexion motions.  The medial migration of the left implant is also making it look like your left nipple is rotating a bit laterally in the photos. This sort of migration can lead to thinning of the medial tissues and palpable or even visible rippling in the area, even with silicone.   It is hard to assess this more accurately with limited photo views and without dynamic motion assessment, and direct exam by a board-certified Plastic Surgeon experienced with augmentation revisions is going to be your best way to sort this out if you are worried.  I hope that this helps.   

Best wishes,    

Tom DeWire, MD, FACS    

Richmond, VA

Thomas M. DeWire Sr., MD (retired)
Richmond Plastic Surgeon
4.3 out of 5 stars 35 reviews

Result offer breast Augmentation

Actually your shape is pretty close to what many plastic surgeons would consider ideal. There is fullness and thoroughly in a nice gentle slope superiorly. Interestingly this is at odds with what some patients feel is a good result. I have heard of this dichotomy talked about plastic surgery meetings. Many American women like a fuller, rounder look superiorily because that is what we see idealized in the media. Actually, you have a very nice result. You have some asymmetry but this is consistent with your preop situation

Ben Lee, MD
Denver Plastic Surgeon
4.5 out of 5 stars 25 reviews

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