What is the best option to correct implants that are bottoming out? (photo)

Your implants are bottoming out because they are too large and heavy for your tissue. I would suggest going smaller than 400 cc's and doing another lift. You might now need mesh as well.

Dear Fearless738593,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

I’m sorry you’re dealing with these issues after your revision surgery. Revisions can be frustrating, because sometimes the muscle and skin are stretched out differently on each side, and this can lead to a different appearance after surgery.

I think you are right on track with your plan for repair. Downsizing the implant and performing a lift will help your implants fit on your chest better, and it will not stress and stretch the lower skin quite as much. You could also consider a sling to help minimize stretching and to prevent the muscle from riding too high, which eventually pushes down on the implant.

Best wishes for the result of your dreams.