Going in for Capsulorrhaphy in Aug to Fix Bottomed out Implant? (photo)

I am going to have a capsulorrhaphy in Aug. I had 400 cc silicone implants done and right away noticed that my breast were uneven and my surgeon told me I had bottomed out and needed this done. I have included a picture and just want your opinion on whether I could go with a larger implant or because of my height 5 ft 6 in, weight 115 pounds and age 47 if a 400 cc is the largest I can safely go. I feel like my breast still look small.

Doctor Answers 12

The Benefits of a Lift with a Capsulorrhaphy

The most common #breastprocedures include #mastopexy or #breastlift, #breastaugmentation, or #breastreduction. A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy. Also, a breast lift may also be achieved with current implants if a patient is satisfied with their current size, type and volume.

Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct height may also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Active weight transfer to reverse bottomed out breasts

Your photograph shows asymmetry of size and areola position, your breasts are too low and have bottomed out.  The implants you have now are 400 cc, which are too heavy and your body cannot withstand that weight (about 1 pound) and will descend further.  I recommend Breast Augmentation with Mini Ultimate Breast Lift.  This will align your areola, breast tissue and implant all over the bony prominence of the chest to increase cleavage, upper pole fullness and projection with a smaller implant.  This technique produces long term stability by minimizing implant weight and active transfer the breast weight to the underlying muscle.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Capsulorrhaphy and Larger Implants?

   A capsulorrhaphy to repair the fold to prevent bottoming out and placing a larger implant at the same time can be done, but the larger implant will place more stress on the repair.  Most plastic surgeons would not recommend implant upsizing and pocket reduction at the same time.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Bottoming out and implants

If you have had problems with bottoming out, I often place smaller implants back in because the pocket is often made smaller.  Going bigger is probably not a great idea.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Larger Implant Will Increase Risk Of Repeat Bottom-out

I think you will increase the risk of having a recurrent bommoming out problem if you increase the volume of your implants.  The use of Strattice, etc. would be associated with a higher success rate, but will also add significant cost.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

The Larger the Implants the Higher the Risk

Thank you for your question.  You are correct that a larger frame patient can safely have a larger implant without significantly increasing your risks.   Unfortunately, you have already experienced one of the possible complications of having a larger implant...malposition.  Larger implants have a higher risk of wrinkling, palpability, capsular contracture and malposition.  I would recommend that you get this problem solved first.  Larger implants would potentially also put the capsulorapphy at risk due to the weight of the larger implant.  Best wishes.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Capsulorraphy ain implant size increase

Defining implant size to be used to reach your goals is very important.  Larger implants may be used at the same time as a capsulorraphy in certain cases as long as the structure is appropriately reinforced to sustain an increased weight and pressure.

A thorough discussion with your PS is essential for the best final outcome!

Best wishes for your corrective procedure!

Mario Diana, MD
Plano Plastic Surgeon
4.5 out of 5 stars 28 reviews

Capsulorraphy for Breast Implant Bottoming Out and Going Bigger?

Thank you for the question and picture.

Capsulorraphy surgery can be very successful in correcting breast implant malposition problems. I would suggest that you discuss your goals and concerns with your plastic surgeon carefully. Communicate what you would like to achieve in regards to breast size and ask your plastic surgeon to do so, with the first priority being safety ( avoidance of recurrence of the breast implant malposition).

 In other words, it may be possible to go larger safely;  often this type of decision is best made during surgery, after the repair (capsulorraphy) has been completed. Careful measurements at that time will allow your plastic surgeon to determine whether a larger breast implant can be used safely.

 Again, preoperative communication ( in my practice I find the use of goal pictures helpful) will be very important.

 Best wishes with your upcoming procedure.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Considerations for fixing bottomed out breast implant

The simple answer to the question of whether you should go larger when having a capsulorrhaphy for a bottomed out implant is that the larger implant will put more stress on the repair and lower the odds of success. The separate question of whether a larger size is appropriate for your frame has to do with subjective factors (what you want) and objective factors (the physical dimensions of your frame.) A base diamter measurement would be helpful but my guess is that larger implants would not be ideal.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Going in for Capsulorrhaphy in Aug to Fix Bottomed out Implant?

You need more than a repair of the left bottoming. Your result is very asymmetric. Seek IN PERSON opinions. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 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.