Bottoming out - will underwire bra prevent more bottoming out? (Photo)

Question

Utm 450cc 1 year ago My doctor told me that my bottomig out was slight and to just wear an underwire bra. I am concerned that it will just get worse.

Semih Yildiz, MD, FEPOBRAS · Answer

From your photo, the implants do appear to sit somewhat low with more fullness in the lower pole, so mild bottoming out is a reasonable concern. A photo alone cannot confirm how much the inframammary fold or implant pocket has stretched, but your surgeon's advice to use support is a common conservative first step when the change is mild and stable.

An underwire bra can help support the breast and may reduce downward pressure on the lower pocket while you are wearing it. However, it does not truly repair bottoming out, tighten the capsule, or permanently move the implant back up. If the fold has stretched, a bra may slow additional stretching but it cannot reliably prevent progression by itself.

At one year after surgery, the implants are usually in a fairly settled position. If the appearance is not changing and the bottoming out is slight, observation with a well-fitting supportive bra may be reasonable. Make sure the wire sits at your breast fold and does not dig into the incision or push the implant into an uncomfortable position.

If you notice the implant moving lower, the nipple looking higher on the breast mound, increasing asymmetry, new discomfort, or a visible crease problem, you should be re-examined. Revision options can include tightening the lower pocket, reinforcing the fold with an internal bra technique or mesh/ADM in selected cases, and sometimes changing implant size or pocket position.

I would continue follow-up with your surgeon and consider a second opinion from a board-certified plastic surgeon if you are unsure or feel it is progressing.

Daniel Barrett, MD · Answer

Dear Inventive954375,
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

Connie Hiers, MD, FACS · Answer

It is still slight. yes, wearing an underwire can be helpful. Always wear a good supporting bra, especially when exercising.

Camille Cash, MD · Answer

If you are bottoming out a more supportive bra can help slow progression sometimes, but it will not reverse it.  Bottoming out can be surgically corrected.  Sometimes bioabsorbable mesh is used to give more support to the tissues.  I've included a video I hope you find helpful.

Bottoming out - will underwire bra prevent more bottoming out? (Photo)

Answers (4)

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