Implants have bottomed out - should I go through with a revision? (photos)

I agree your breasts look great in a bikini. Even with the bottoming out they still look good without clothing. My personal opinion is to procrastinate on surgery.

I would recommend exchanging the implants and supporting them with Galaflex. In addition, I would perform an inferior mastopexy to help decrease the nipple to fold distance. What usually happens is that the implant stretches out the lower pole of the breast over time. Initially the implant position seems adequate, but the lower pole stretch always happens. I would highly recommend finding a highly trained aesthetic plastic surgeon (preferably 6 years of dedicated plastic surgery residency and 1 year of aesthetic fellowship). Best of luck!

Women who need a breast lift who've been heavy in the past or who just happen to have more loosely elastic tissue are more prone to drop out than other women. Your recent weight loss likely had no impact on what you're seeing now. Although you've dropped out, I think that you should proceed with a revision surgery to reposition these or large implants with the additional support of an absorbable mesh. In addition, extra skin may need to be removed to shorten the vertical scar, but possibly not if larger implants are used. Please keep in mind that larger implants drop out more frequently than smaller ones.

Dear Unicorn4456,
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

Thank you for your question. You are right, and that your implants have bottomed out. Weight loss can certainly impact bottoming out as your skin loses some of its elasticity. The correction for this would be to decrease the distance from your nipple to your IMF. Placing larger implants will definitely increase your risk for bottoming out again as you’re adding more weight which will get pulled down by gravity. My recommendation at this point would be to add an internal bra for added support. With that being said, there’s no reason for you to undergo surgery unless you get to the point where you are Consistently unhappy and are willing to undergo another procedure. There’s no downside to waiting. Good luck.

Weight loss can potentially impact the appearance of breast implants. Significant weight loss can cause changes in breast volume and tissue support, which may contribute to the bottoming out of implants. Additionally, skin elasticity may be affected by weight loss, potentially affecting the positioning of the implants.

Techniques to enhance support, such as internal sutures or the use of acellular dermal matrices can prevent or correct bottoming out . During a consultation, the surgeon can provide guidance on choosing a suitable implant size that would achieve the desired aesthetic result while maintaining proportion and balance with your body.


I hope this helps,
best of luck !

If you are ok with your breasts, then do nothing. However, do not go larger since larger is heavier and will sag even more.

Dear Unicorn :-),
If you are happy with your breasts, then leave them alone.

Yes, moderate weight loss can significantly change the way breasts look. This may appear as loss of upper pole fullness, or the appearance of lower pole fullenss...'bottoming out'.
You may increase your implant volume which gives you more upper pole fullness (consider a higher profile implant [ more projection out from the chest and are narrower] to avoid a wider appearing breast).

Dear Unicorn,
Your 25 lb weight loss undoubtedly had an effect on your breast lift results. It likely caused further loosening of your breast skin, which is why you needed a breast lift in the first place. A breast lift revision would help to recenter your breast tissue over your implants. Larger (read: heavier) breast implants are probably not the best idea because they will age faster, i.e. stretch out your revision breast lift and scars. Good luck!