Why Does my Implant Look Bad?

How come 15 months post op, my silicone gel implant on my left looks as if its sagging really bad making it look terrible compared to my right? I hate it so much, to the point where i regret getting them done. I cant even wear a bathing suit with out other people noticing that they are no leved correctly. What should i do, please help...

Doctor Answers 14

Implant Migration

Why is it over 1 year after your breast implant surgery the implant shifts or moves.  No doubt the weight of the implant and gravity have caused your skin to stretch in the lower pole of your breast and now your implant is sitting too low on your chest wall.  You are complaining now, so I will assume it was in good position initially after your procedure.  Why does this happen and why not to the right breast as well?


I have seen at least 6 women recently who have the new silicone implants where this exact phenomenon has occurred.  There may be a problem with the silicone implants that is now just surfacing.

You will need a revision surgery to re-position your left implant to a higher position on your chest wall. Please return to your original PS so he can help you.  I don't know how to prevent this from occurring again.

Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Bottom out

Besides what the other doctors have correctly noted, it also appears as if you have large implants. I find that the larger they are, the more problems you can have.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Implants have bottomed out

It appears as if your breast implants have "bottomed out".  This can be corrected with a revisional surgery, bringing the breasts to the same level and symmetry.  Typically, revision surgeries following breast augmentation reposition the breast with nice results. 

Robert N. Young, MD, FACS
San Antonio Plastic Surgeon
4.6 out of 5 stars 70 reviews

Bottoming Out Of Implants

I agree that your left breast implant has "bottomed out".  A likely contributing factor here is probably the fact that your implants are too large.  It is very important to use implants which are the appropriate size.  This means implants which are no larger in diameter than the breast width.  Implants which are too large potentially cause many problems such as "bottoming out", capsular contracture, "fake look", etc.  Many women want a larger breast size post-op than be achieved with an appropriate implant.  They must then be willing to accept these other problems if they arise. 

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

Why does my implant look bad?

It appears that you have suffered a "drop out" or inferior malposition of your left implant as the implant has stretched the tissues on that side.  That is why it is lower and the distance between the nipple and the inframammary crease has elongated.  Assuming that your right breast is soft (and not being held higher by a capsular contracture (or tight scar tissue squeezing the implant) and therefore does not need intervention, the treatment is to reposition the left breast higher up on the chest.  Keeping it there is the problem, as you are fighting gravity.  Some surgeons would try to suture the old pocket closed, but there is some recurrence risk as the sutures may pull out.  Some surgeons would dissect a new "neo-subpectoral" pocket, close down the old pocket, and I have had good success with this. Some surgeons would recommend using an "acellular dermal matrix" or dermal substitute such as Strattice to help support the tissues, especially if your tissues are thin, but be aware that this material is very expensive and does add two to three thousand dollars in cost to the procedure.  Discuss this problem with your surgeon or get additional opinions.  But be reassured that the problem is fixable.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Implant malposition

Based on your pictures, I agree that it looks like the implant on your left has bottomed out.  You will likely need an additional surgery to help reposition the implant to help achieve a better symmetry.  


Good Luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Breast Implants - Why does my implant look bad?

Hi Jen,

It looks like your left implant has "bottomed out."

I cannot, of course, say for sure without being able to examine you and, also for sure, you should talk to your PS about this.  Assuming that that is the case, there are several choices in terms of what can be done surgically (I don't think that there's much that can be done without another surgical procedure).

First, the implant can simply be elevated into its ideal position and the bottom portion of the "pocket' (the space where the implant is) can be sutured with a series of sutures (stitches) that should help support it in place while it heals.  There is a certain rate of recurrence with this, but it's the simplest approach and has often been successful.  A new pocket can also be created, but you'll still have the issue of blocking off the bottom of the pocket.

More recently, the addition of acellular dermal matrix (ADM) has been suggested to rebuild the lower portion of the pocket.  Used commonly in breast reconstruction cases, it is a valid option here, although it is expensive and, as with all procedures, there are potential downsides to this, too.

In sum, I think you'll need another procedure to elevate (and maintain the elevation) of the left implant.  You should research the options and then speak with your PS.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Breast Asymmetry 15 Months Post Augmentation

It's difficult to determine the reason for #asymmetry without seeing before photos. Breast revision surgery is performed for a number of reasons and factors related to the patient’s initial breast surgery. One reason is asymmetry. However, there's no guarantee the #asymmetry will simply be resolved with one breast revision. There are various reasons breasts can appear uneven or asymmetrical; which have to be taken into account when your surgeon determines the appropriate approach and technique for your #revision surgery. Typically, it's best to wait 6 to 12 months depending on the reason for #revision.  Matters such as sagging or drooping  and size change will not improve with time. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Left Implant Has Bottomed Out

It appears from your photograph that your left breast has " bottomed out."  This is when the implant pushes past the natural fold of your breast for whatever reason.  This is usually easily correctable by reiniorcing the inferior pole of the breast and the fold internally with either your own tissue capsule or some synthetic material such as Strattice.  I would go see your plastic surgeon and discuss it with them.  The surgery is generally straight forward, easy to do in experienced hands, and is a pretty stable result.  It is worth it to achieve better symmetry and balance.  I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.8 out of 5 stars 75 reviews

Asymmetry post augmentation

Dear Jen2456,

Thank you for the photo which demonstrates your deformity.  I suggest that you call your original Plastic surgeon for his/her evaluation.  Bottoming out requires surgery to correct.  If you do not feel comfortable with your original surgeon's plan, ask him for a referral to another plastic surgeon who may feel more comfortable in re-operative breast surgery.  Good luck


Craig Harrison, MD, PA
Tyler Plastic Surgeon
5.0 out of 5 stars 32 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.