Have my breast implants bottomed out? (Photo)

Thank you for your question. In the pictures, you have sent, I can see that lower pole looks a little long and the fact that the incision position is now higher than the implant, means that you are dealing with slight bottoming out (inferior malposition). Judging from pre-op picture, your breasts tend to have a longer pole naturally, so your results are reflected with the original breast shape. Of course, the result would be better if the scar level is aligned with the implant borders, but I would not consider your result as necessarily very bad. Slight malposition of smooth implant is normal for people with thinly formed implant capsule, so they usually need to have an additional support from bras with under-wires which is wide enough to support your breasts.

Your breast surgery result looks very nice. At first glance of the photos, the implants do look a little "bottomed out", meaning the implant is sitting mainly in the lower portion of the breast, however, when I look at your pre-op photo, I see that you do have a little bit of a high nipple with more lower pole than average. You do not have a bad result, you have a very good result.
All the best to you,
Dr. Nancy de Kleer

Good afternoon,
You do have some bottoming out, which I correct with the Original Internal Bra- my strong permanent internal suturing technique. I first developed this technique 20 years ago, and today it is the most common revision procedure I perform, 5-6 times a week- it works and it lasts!

Thank you for your question.

The breast, which is mainly composed of skin, adipose tissue and mammary gland, is fixed to the rib cage by the resistance of the skin and suspensory ligaments. If suspensory ligaments are loose and skin tension is low, a breast may sag regardless of its size. Even breasts with small volume may sag due to loosening of the skin and suspensory ligaments due to births and breastfeeding. At the same time, even though it is large, a breast with strong skin structure and ligaments might not sag. As a result, the characteristics and structure of each breast differ from one another.

Thank you for sharing your question and photographs. What is most important is that you like the way your results have turned out. If that is so, enjoy them and do not worry about what they are considered.

Dear Jane_doe89,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your Question.
there are multiple factors influencing the actual size increase a breast implant will provide other than volume, including:
Implant profile (projection) and base widthImplant shape (i.e., classic round, teardrop shaped, extra upper pole fullness)How much natural breast tissue you haveThe width and contour of your rib cage

Your results are not bad, but you do have some bottoming out. I would suggest wearing underwire bra during the day and a good support bra when exercising. I do not recommend surgery at this point.

Thank you for the pictures. Unfortunately, you are correct, the implants have settled downward or "bottomed out". It is more likely they were just placed too low this early after your initial surgery. Make sure to discuss this with your surgeon. There are multiple ways to address this problem.