From the Pics, Has my Left Breast Simply Just Bottomed Out? Dropped Before the Right or Another Problem Altogether? (photo)

My left breast is very soft & the most natural looking & the incision is sitting perfectly under the crease. My right breast is however, still somewhat firm & the insicion is still above the fold. Are there any tips or techniques to help my right breast drop faster, if indeed that's what the problem is? The first pic is from a saline filled 275/270cc Inamed (McGhan) 468 (that I had for 13 years. The second & third pics are from my new 350cc Mentor moderate plus profile silicone gel implants (surgery date July 21, 2011). The second pic is 2 weeks post surgery & the 3rd is from Nov 1st (aprox 4 months later). It seems my left breast just dropped overnight if not a few days. What has happened? Should I wait further or look into a revision? 

Doctor Answers 8

Has Your Left Breast Bottomed Out

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It may be best to consult with your plastic surgeon to explore your #options. The term "Bottoming Out" is 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.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Bottoming out right breast

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Thank you for the question and the photos. Your right breast has bottomed out. The good news is there is a way to fix it. You need to have internal sutures to repair the capsule inferiorly and correct the breast shape. I think you should wait for few more months and then have it repaired.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Bottoming out

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It looks like one of the breast in the photo has bottomed out. It is lower than the other one and appears to be below the origianl fold. This can happen in some patients and often requires a fold revision.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Yes, your left breast (left in the photo) appears to have "bottomed out"

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Hello, It appears from your photo that your left breast (in the photo) has "bottomed out", which means that the left breast pocket has enlarged or stretched. This can be repaired by suturing the lower breast pocket which is called a capsullorhaphy. All the best, Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

The bottomed out breast implant

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As you had implants before there was no need for your implants to 'drop'. An implant will drop or settle into the breast envelope as the skin in the lower breast gives and relaxes to accommodate an implant. Your implant has drifted low in the breast, an bottomed out. The middle picture is great, and perhaps a repair of the breast fold will get you back to that point.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Dropped and bottoming out breasts: Achieving beautiful and lastingrevision results

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Unfortunately your right breast has indeed bottomed out or dropped below the aesthetic position.  Your right breast is also too low and will probably progress just not as bad as the left.  This is very common in dual-plane submuscular techniques as they provide no inferior support and have the constant down and out force of the pectoralis muscle.  In my opinion the only good solution for this problem is a conversion to a subfascial placement.  This is the only way that I feel can offer lasting structural support and a beautiful natural shape.  That is why I developed the COLD-SUBFASCIAL technique which avoids thermal and traumatic injury to the pectoral fascia which is responsible for the success of this technique.  While most would advise you to wait, the issue you are unhappy with certainly will not get better on its own and in my opinion it is safe to proceed at 4 months.  Your other option is to accelerate the dropping of the left implant with strapping pressure and massage, they woould both be quite a bit lower than ideal but symmetric.  I hope this helps.


All the best,



Rian A. Maercks M.D.

Which side has dropped? Waiting is good

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First of all there seems to be some confusion going on here.  Remembr that a picture is a mirror image and left and right sides get reversed.  On the last photo it is your right side that is lower and the left side is higher.  Unless you took the picutres yourself standing in front of a mirror, in which case it is reversed.

Whichever side hads dropped first it may be that the same phenomenon will happen to the other side in the next few months.  Fixing it by raising the fold is not too difficult for the surgeon but is always is disapointing when the other side then drops too.

Why does this happpen?  It depends on how close to your skin the pocket was formed by the surgeon.  When it is just skin holding up the implant then at times the skin stretches out just enough for this to occur.  I would wait for six months.  If it hasn't happened to the other side then a revision to tighten the bottom of the affected pocket would fix it.

Breast Asymmetry after Breast Augmentation?

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Thank you for the question and the pictures series.

I would agree with you that left breast implant has “dropped” too much. This drop has caused the distance from the areola to the inframammary fold to be too great. It also makes the nipple/areola complex seem off centered (too high) on the breast mound.

I would also agree that it would be in your best interest to wait at least a few more months before contemplating revisionary surgery. This  wait time will allow the implants to  be in their “final” positions ( it would be a shame if the right breast implant changed after you had already undergone revisionary surgery).

Revisionary surgery may involve left breast inferior capsulorrhaphy ( use of permanent sutures to repair the breast implant capsule to provide additional support for the left breast implant).

I hope this helps.

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.