Bottomed Out 6 Months After Breast Implant Surgery

I had saline implants placed 6 months ago and they have already "bottomed out." My surgeon wants to replace my smooth implants with textured ones and I am concerned about rippling. The Dr will also fold and place permanent sutures along the bottom muscles to prevent bottoming out again. Is this the best solution? Should I ask to keep my smooth implants instead of textured?

Doctor Answers 2

Bottoming out correction

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I like to wait  at least 6 months prior to correction of inferior displacement of breast implants (bottoming out). This allows for the capsule tissue around the breast implant to have increased strength and hold sutures better (capsulorrh theaphy)- I think this allows for improved chances of successful repair. Be careful because, in my experience, folding of the capsule tissue is not enough to get a lasting results (some capsular tissue must be removed). Allograft reconstruction may also be helpful, especially if the implant malposition problem is recurrent.


In my opinion, this reconstruction (capsulorrhaphy) is  what will lead to successful results, not the texture of the implants chosen.

Make sure you are seeking consultation with a well experienced board-certified plastic surgeon. Best wishes.

Textured Implants have positive and negative aspects

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I am sorry to hear your Implants bottomed out already six months after your surgery. A photo would be really helpful to evaluate your condition. Regardless of the reason they did, you have a few options.

A textured implant tends to stay in place due to the fact that it is less mobile during the formation of the capsule around it because of it rough texture. That is a positive aspect when trying to avoid "bottoming out". But as you mentioned it has a harder outer shell and may ripple and be more visible on a thin patient or even worse if your surgeon places your implants in the sub-mammary plane. If you want to avoid the textured implants sutures to recreate the infra-mammary fold (permanent or absorbable) can help with wearing a supportive bra for at least 3 months. Another new tool available to the plastic surgeons is a biological internal bra or support such as Strattice. It creates a thicker substance to suture to and creates a sling to hold the implant from dropping. It is expensive and has its own risks such as seromas and infections and needs to be used by someone with experience with it.


Good luck!!!

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.