Bottoming out would mean the implant is sliding
down your torso. In your case, you would benefit by a breast lift or mastopexy.
I think you should reconsult or get a second opinion.
I hope this has been helpful.
Robert D. Wilcox, MD
Surgery is the only effective remedy. Revision surgery is almost always more complex than breast augmentation. Correction techniques vary based on your plastic surgeon’s experience and skill sets. Always choose a board certified plastic surgeon with expensive revision experience as even in the best of hands recurrence is frequent especially if larger implants are used. Repair techniques include some of the following techniques and recommendations:
- Textured implants (“Velcro effect”)
- Use of Smaller Implants
- Maximum Submuscular Position (not just the pectoralis major but abdominis rectus below and serratus anterior on the side)
- Capsulorrhaphy (tightening the pocket by sewing in-folded capsular tissue together)
- Use of Biologic fabrics and other materials such as Acellular Dermal Matrix, “ADM” Alloderm, Strattice, “Silk” and others that can be used to reinforce the bottom of the pocket.
- Change of position of implant to a new pocket location “neo pectoral pocket”
- Internal Ryan Procedure (sutures binding the inferior mammary fold to stronger underlying tissues (e.g. fascial, periosteal)
- Removal of Implants and replacement of volume using your own fat (Fat Transfer).
The procedure is performed under general anesthesia on an outpatient basis most often using an existing scar or making an incision beneath the breast. Recovery is similar to your original breast augmentation procedure. Use of taping after surgery and prolonged use of a support bra is often recommended. It is far more important to pick the best plastic surgeon rather than trying to pick the best procedure as they are in the best position to guide you to the right decision.
A revision with a lift and some internal support may be necessary to achieve the look you desire. Discuss your options with a board certified plastic surgeon in your area.
Hello dear, thanks for your question and provided information with pictures as well.. It seems that you're bottoming out, you need to have a revision also, get an appt with your plastic surgeon
I am so sorry that you are bottoming out. Schedule an appointment to speak with your surgeon about your revision options. You also may want to speak with him about a breast lift. Best, Dr. Nazarian
To address your sagging and possible bottoming of your implants, you will need to consider a breast lift. In addition, depending on the quality of your tissue, you may need to opt for the internal bra technique with SERI surgical scaffold. Remember, your implants can only be held up by your breast tissue. If your tissue is weak, then the implant sagging will reoccur even with breast lift. In these cases, you need to bring something else in to provide additional soft tissue support to your implants. This something else is the internal bra technique. Please see a board certified PS with extensive experience with these techniques to learn more about your options. Best wishes,
I am sorry to hear about your concerns after breast surgery. Based on your description, you are experiencing a breast implant displacement problem. Adjustment of the breast implant capsules may be necessary to improve your outcome. Based on your photograph, breast lifting may also be indicated.
My best suggestion: seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients with this type of revisionary breast surgery. You may find the attached link, dedicated to revisionary breast surgery concerns, helpful to you as you learn more. Best wishes.
My recommendation is a breast lift to tighten the skin envelope and improve the nipple position over the central breast mound. Also, you will likely benefit from tightening the internal capsule or lining of the implant pocket to help the slight bottoming out and lateral malposition that appears when you lie down. You should seek the advice of a board certified plastic surgeon who has done many revisionary breast augmentation procedures.
Dr. Ravi Somayazula
I agree with the other docs, hard to say exactly but would probably benefit from and internal sling like strattice or Seri, hold the implants in a higher position and take the strain off your breast tissue, seek a BC PS with experience in revisions, good luck!
Thanks you for your question and images. From your pictures I would not say they are bottomed out.
Bottoming out would mean that most of the implant sat below the nipple but the relationship od implant to nipple looks correct however I agree that an uplift could improve the appearance but at the expense of scars so you should discuss in fall with your PS.