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

Question

Hi! Last September I had my 12 year implants replaced (saline 390/420). I loved the way they looked but was lacking some fullness and had ripples after kids. They were replaced with 520 gummy bears and shortly after one bottomed out and I had tacking done to correct. I’m not sure if it didn’t work, but I am left with two completely different looking breasts that are too large/wide for my body. What is my best option to correct? I am thinking I will need a small lift and would prefer 400cc

Daniel Barrett, MD · Answer

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

Dana Goldberg, MD · Answer

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.

Gary M. Horndeski, MD · Answer

At this time, I recommend explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

I don’t think you need a lift. You might go with smaller implants and close off the lower portion of the implant pocket from inside  called a cadpdulirrsohy

Connie Hiers, MD, FACS · Answer

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.

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

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

Answers (9)

Answer: Breast implants

Answer: Breast implants

Answer: Implants

Answer: Implants

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.