I have bottomed out 3 times- should I explant?

Question

3 surgeries with bottoming out all within 6-12 months. Augmentation was under the muscle. My last surgeon from March 23 and I have been watching this happen since 4 months post op (same with other 2). He will fix it and make it "agressive". I am thinking doing the same thing over and over again won't fix this. I have horrible animation deformity (ext Boobs fall out of my bra, they ache and they sit out to the side now low low low. Help?

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs.  However, if you have bottomed out 3 times, I do not think the 4th time will be the charm.  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.

Shaher W. Khan, MD · Answer

Hello, thank you for your question!! Please watched the attached video that provides a detailed response to your question specifically. I am sorry to hear that you've been struggling with these issues. It sounds incredibly frustrating and painful. Options could include capsulorraphy (tightening of the capsule to prevent the implant from moving) or a mesh/sling (internal mesh to support the implants from bottoming out) as I have described in my video. Consulting a surgeon who specialized in complex breast surgeries or reconstructive surgery may provide new insights or alternative approaches. It is valuable to seek opinions from multiple surgeons to explore all potential options and ensure that you are making an informed decision.

Daniel Barrett, MD · Answer

Dear Dazzling4087,
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

Alan Gonzalez, MD, FACS · Answer

Hello @Dazzling4087, thank you for your question. You should have an explant with total capsulectomy and since you have good breast tissue I would consider a breast lift to rearrange the breast tissue and lift the areolas and nipples. The shape of the breast is improved by rearranging the breast parenchyma.  I understand your concerns regarding breast animation deformity and chronic pain. It is possible that the underlying cause of the symptoms is related to the pectoralis muscle attaching to the chest wall. However, a thorough consultation and examination would be necessary to determine the cause of the problem and treat it. To shed more light, I share a video. If you are considering breast explantation, consultation with a plastic surgeon experienced in this procedure is essential to ensure optimal results. Best regards.

Alan Gonzalez MD, FACS.   Member of the International Federation for Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).

Tyler Frew, MD · Answer

Hi there,
Can you provide some more details about your previous surgeries, including your implant sizes, and some current photos. That way we can better answer and provide help
All the best

I have bottomed out 3 times- should I explant?

Answers (8)

Answer: I have bottomed out 3 times- should I explant?

Answer: I have bottomed out 3 times- should I explant?

Answer: More information needed

Answer: More information needed

Recommended reading

Everything you need to know about Breast Implant Removal

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

I have bottomed out 3 times- should I explant?

Answers (8)

Answer: I have bottomed out 3 times- should I explant?

Answer: I have bottomed out 3 times- should I explant?

Answer: More information needed

Answer: More information needed

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

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