I had a breast Aug on 3/30/16 and it looks to me as it my right breast has "bottomed out"? (photo)

I had a breast Aug on 3/30/16 & it looks to me as it my right breast has "bottomed out" ? I didn't have another appt w/my PS do you think I should contact him about this or is this just a case of one of the implants dropping & fluffing before the other ?

Doctor Answers 11

Right breast has "bottomed out"?

Unfortunately it does look like your right breast has descended. You may be able to improve this with vigorous breast strapping, and you should see your surgeon asap. Good luck, Dr Steve Merten, Sydney, Australia

Sydney Plastic Surgeon
4.9 out of 5 stars 48 reviews

Right Breast Bottommed Out?

Hello,Your Right breast implant does appear to have settled below the set fold. Breast implant volume is no longer centered behind the areola on that side. You will need to book an appointment with your Plastic Surgeon to be examined and discuss options for correction.
All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Bottoming out

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

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

Short answer, yes. See your plastic surgeon.

It appears that you have bottomed out a bit but from the photo, more importantly, you have some asymmetry with you right breast implant appearing to be a bit lower than your left, resulting in a visible asymmetry at the top of your breasts which may be apparent in bra, bathing suit, or certain clothing. It appears that you have high profile implants, which makes them a bit round in appearance. Any and all concerns should be discussed with your plastic surgeon. If you remain dissatisfied for whatever reason you can always seek a second opinion to compare thoughts, but if things do not get worse and you feel you can live with your present situation for the time being, then perhaps you can defer any action for the time being. Best of luck to you. 

Ram Kalus, MD
Mount Pleasant Plastic Surgeon
4.8 out of 5 stars 23 reviews

Bottoming out

Yes, you should see your surgeon in person. It looks like you need a pocket revision to reposition the implants.

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

Breast augmentation result

A agree that one of your implants appears too low and has probably bottomed out. You need to return to be evaluated by your surgeon and discuss revision options. Good luck,

Scott W. Vann, MD, FACS
Savannah Plastic Surgeon
5.0 out of 5 stars 4 reviews

I had a breast Aug on 3/30/16 and it looks to me as it my right breast has "bottomed out"?

Thanks for your question and picture.  It does appear that your implant on the right side has dropped too low.  If you are concerned about your result, you should contact your surgeon and have a follow up appointment.

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 74 reviews

Right breast has "bottomed out"?

I am sorry to hear about/see the problem you are having after breast augmentation surgery. I think your concerns are appropriate; one of the breast implants does seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”).

 Consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low.  Also, consistent with the implant displacement concern, the  inframammary scar is more visible.

I think you will likely benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair). This procedure serves to reconstruct the lower poles of the breast and prevent migration of the breast implant too far inferiorly. Associated issues with positioning of nipple/areola complexes and visible scar should improve with this operation. 

Make sure that the plastic surgeon who does this procedure for you can demonstrate significant experience with revisionary breast surgery. 

I hope this, and the attached link (dedicated to corrective surgery for bottoming out concerns), helps.

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

Breast Augmentation

Thank-you for your question.  Please contact your doctor and discuss your concern with him/her.  It is best to have the surgeon who did the procedure explain the surgery to you and review your pre-operative and post-operative photos.  Good luck!

Saira Saini, MD
Fayetteville Plastic Surgeon
4.3 out of 5 stars 6 reviews

Bottoming Out After Breast Augmentation

It does have the appearance of bottoming out that can potentially be corrected with tightening the pocket. I would schedule a return visit to your plastic surgeon to get an evaluation.

Christopher J. Ewart, MD
Augusta Plastic Surgeon
4.8 out of 5 stars 44 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.