Have I bottomed out 4 days after Breast Augmentation. Any suggestions? (photos)

It feels much more loose in the right breast ... I had more loose skin prior to ba and the swelling seems to have went down but have I bottomed out ?

Doctor Answers 15

Breast Asymmetry

Judging by your photos it does appear that you have some breast asymmetry.  Your left breast is very different than your right breast and breast augmentation surgery can at times accentuate the asymmetries that are present before surgery. 

It appears that your left breast has more skin below the nipple and areola with a higher placed nipple and areola with a tighter skin envelope than the right breast.

At this point it is best to allow the healing to take place and re-evaluate your results in 4-6 months.  At that point your plastic surgeon and yourself to see if there is anything that can be done to provide you with a more symmetric result.

Good luck.

Orange County Plastic Surgeon
5.0 out of 5 stars 77 reviews

Breast augmentation healing

Thank you for the photos.  Its hard to tell with the bandages in place.  I do see the asymmetry between the breasts but there are no pre-operative photos to compare with.  I think seeing the before photos, the current breast fold, and possibly an in person exam would be needed to determine if bottoming our is occurring if there are asymmetries of the breast implant pockets.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Bottoming Out?

Thank you very much for your question.

While the pictures are helpful, an in-person examination with your plastic surgeon at this point would be best to determine if there is any bottoming out, or any maneuvers that can be done to improve some of the asymmetry you have.  You are only 4 days out, and many times after surgery breasts may "behave" differently before finally equalizing out.  Again, input from your surgeon will be helpful.  Best of luck!

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 23 reviews

Visit your PS

Thank you for the question. It would be difficult to fully assess your situation without an in-person examination.  At 4 days you are still fresh from surgery so it is not uncommon to have asymmetries at this point but best to visit your board-certified plastic surgeon and have a full evaluation. Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 90 reviews

Are you bottoming out?

It would be difficult to help you without an in person examination. You should make an appointment with your plastic surgeon. Large Implants due to their weight, gravity, thinning of tissues, chronically not wearing a bra, loss of elasticity and other factors may cause continued stretching so that your breast implant is no longer supported in its ideal position. This results in the progressive lowering of the inferior breast crease (inframammary fold). When the implant moves South to an undesired inferior position it results in the loss of volume and flattening of the upper pole of the breast, too much volume at the lower pole, increasing the distance from the fold to the nipple and finally the nipple position being abnormally high ( pointing up) and not centered. Similarly, the pocket can also stretch to the side (lateral) so that when lying down your implants fall towards your arm pits or sides, causing the “Side Boobs” appearance.
Bottoming out and Side Boobs Contributing Factors:
  1. Larger/Heavier Implants
  2. Implants placed above the pectoralis muscle
  3. Chronically not wearing a bra when upright
  4. Over dissection of the Implant Pocket
  5. Smooth Implants
  6. Large swings of weight including pregnancy
  7. Skin and soft tissue laxity, loss of elasticity
You should wait for some time(about 2-3 months) before considering revision as it does take some time for your breasts to settle and the final result to show. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Bottoming out

From you photos, the asymmetry between your breasts which you are referring to is clear.  It looks to me like you had a tighter skin envelope on the left before your surgery (meaning more skin on the right, as I think you referred to).  A breast augmentation can often make an asymmetry like this look more obvious because you have an implant in a smaller, tighter breast with more upper pole roundness and a higher nipple.  It does not look like anything has gone wrong, and you still have a lot of healing to do, so I would not be overly concerned at this point.  If the asymmetries bother you after you have healed, you can talk to your surgeon about options.  Most likely the best way to make your breasts more symmetric would be to do a small lift on the side with more skin.  Best of luck in your recovery!  

Claire Duggal, MD
Annapolis Plastic Surgeon
5.0 out of 5 stars 9 reviews

Bottoming out

Hi. Thank you for your question and your photos. You must wait longer. The implants will be positioned in a lower point in a few months. If you had an asymmetry before surgery it will probably persist after the surgery.  Best wishes for you. DR . DERBY SANG CAPUTO

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 77 reviews

Breast asymmetry

Your breasts are not bottoming out, but it is quite obvious from the pictures that you started with a significant asymmetry that is still visible after the enlargement. Your left breast, being smaller, shows a nipple quite higher than the opposite side, and the implant give more fullness at the top, being in a smaller skin envelope. This situation may improve over time, but not to the point where the breast will be identical. If after waiting for a couple of months you will still be concerned about the difference between the breast you should discuss your options for improvement with your surgeon.

Ciro Adamo, PhD, MD
Italy Plastic Surgeon
5.0 out of 5 stars 18 reviews

Clear asymmetry

Hello, its very obvious that have an asymmetry present. I would be curious to see your before pictures to determine if this is related to your preop anatomy. Other questions would be what type of implant did you have placed, shaped, textured, smooth. Your surgeon would be best to address any early concerns of your asymmetry. 

Paul W. Papillion, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 58 reviews

Have I bottomed out 4 days after Breast Augmentation. Any suggestions? (photos)

Based on the post-op photos, I certainly see the difference, but I don't think that you have bottomed out. It's not uncommon for breasts to heal differently after an augmentation. Sometimes, one implant will drop more quickly than the other. I would suggest a follow up with your plastic surgeon for reassurance. Good luck!

Keith Hodge, MD
Leawood Plastic Surgeon
5.0 out of 5 stars 27 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.