Bottoming out? (Photo)

I had my breast augmentation January 4th. In my opinion..everything looked good and even, but now I feel as though my left is possibly bottoming out? It feels much looser than my right. When I put my arms up in the air my right doesn't change shape.. But the left one kind of does, it seems like the implant does move with it. I've started to now wear a bra 24/7 because I don't want it to continue. Opinions?

Doctor Answers 13

Bottomed Out?

Hello, 

Thank you fro your question. 

It is difficult to say if you are bottoming out without an assessment. I recommend booking an appointment with your Board Certified Plastic Surgeon to discuss your concerns. 

All the best. 

Bottoming Out

Thank you very much for your question.

Based on the picture alone, it is difficult to tell if you are truly bottoming out.  Did you have a fold asymmetry preoperatively?  I recommend continuing to follow along with your surgeon closely, and follow their recommendations during your recovery.  They will recommend a bra or taping strategy if they feel it would be helpful.  Best of luck!

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 19 reviews

You are not bottoming. You have asymmetry

Bottoming is different than asymmetry. You have later.  Wearing a bra or not wearing a bra will not make a difference.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 22 reviews

Bottoming out

Thank you  for your question. Preoperative photos for comparison would be helpful to fully evaluate the current asymmetry. However, it does appear consistent with a bottoming out process. This process is rarely correctable with bra wear, however, it is a straight forward correction for you to discuss with your surgeon should you desire some correction. Best of luck!

Bruce Landon, MD
Tampa Plastic Surgeon
4.5 out of 5 stars 16 reviews

Bottoming out?

It does appear your left implant sits lower than your right. I recommend wearing a good support bra and speaking with your chosen surgeon. 

Regards, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews

Bottoming out

After looking at your photos it seems as though your left implant is a little lower and you may want to put a little support in your bra for a few months to hold it up but the fold may need to be lifted surgically.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 56 reviews

Yes you are bottoming out

Hello and thank you for your question.  I am sorry that you are having this issue, but the good news is that it can be improved. Your left breast is bottoming out since a) your left implant sits lower than your right, b) your left nipple to inframammary fold distance is longer than on your right and c) your nipple has a slight upward tit. 

The way to fix this is a) score the capsule superiorly so that it allows the scar around the implant to expand and permit it to be able to move up higher, symmetric to your right breast and b) place stitches within your capsule inferiorly to reinforce it and move your fold back up and even out your nipple to fold distance; different surgeons may use different techniques to achieve this but the principle is the same. Also, if there is extra skin that has stretched out, an ellipse of tissue within your fold may have to be excised.

Make sure to seek consultation with a board certified plastic surgeon with expertise in revision breast surgery for your optimal outcome.  I hope this helps!

Sincerely,

Dr. Sean Kelishadi

Sean Kelishadi, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 22 reviews

Breast implants

I agree with your assessment, based on your pictures there is some asymmetry between the two breasts. In person measurements would be helpful. Is this your first surgery or was this an implant exchange? Was there some breast asymmetry preop? I would recommend discussing your concerns with your plastic surgeon and you can then have a plan for correction. Good luck!

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 29 reviews

Is My Left Breast Implant Bottoming Out?

The top on your left breast implant is lower than the right.  The bottom on your left breast implant is lower than your right.  Your left nipple has an upward tilt.  The distance from the top of the nipple on the left to the inframammary fold is greater than on the right. 

All the aforementioned characteristics indicate your left breast implant is bottoming out.  This means that the capsule surrounding your left breast implant is lower than the capsule surrounding your right.  The treatment of choice to correct this problem is a capsulopexy which means capsular lift (not a breast lift).  To increase the chances of this capsulopexy succeeding, if you were my patient, I would add Seri scaffolding to increase the chance of success.


Options for bottoming out

Thanks for reaching out.  It looks like you are correct.  Your left implant appears to be bottoming out.  You probably would want to wait until about 6 months post op before making any decisions.  But the best option in that case especially since it is asymmetric would be revision all breast surgery.  You can keep the implant that is currently being used.  What would be done is that the capsule around the implant would be manipulated and your IMF (Inframammary Fold) would be reinforced.

I hope this helps :)

John Paul Tutela, MD
Livingston Plastic Surgeon
5.0 out of 5 stars 29 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.