Worried I am bottoming out? (Photos)
Doctor Answers 14
All the best
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I would need to see the pre op photos - if you have sleected very large implants say more than 450 cc this problem can be more of an issue - you need to strap tha underside crease of the breast for another 6 weeks plus use a support bra - it may be necessary to revise the lower pole later if it continues
Best of luck in your recovery!
Sincerely, James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science
Bottoming out after breast surgery
Concerns about "bottoming out"
It is very important to have an in-person exam of your breasts along with clear before and after pictures from multiple angles in order to address your concerns. It could very well be that your breasts were like this immediately after surgery, and may not have changed much, or, it could be that your breasts did change.
Please note that it is not uncommon for breasts to heal and adapt to implants at different rates.
As you are currently in the early recovery phase, you will have to wait 3-6 months for implants to settle and for your breasts to achieve final results.
That being said, from the image provided it does appear that your right breast’s inframammary incision is visible but we don’t know if it really has moved up. If the incision really has moved up, this would indicate initial phases of bottoming out. We can also see that both breasts appear lower on the chest.
Here is some information about bottoming out that may help you understand it and be on the lookout for further signs.
- Bottoming out is common when the inframammary fold is released and not firmly sealed and reinforced.
- A weak inframammary fold will result in downward breast implant displacement once the breast implant slips below the natural or surgically lowered inframammary crease overtime.
- Bottomed out implants end up too low on the chest wall with the inframammary scars travelling up onto the breast skin.
- The nipples will not only point upward, but also be positioned higher on the breast mounds.
- There will be no pain, but you may notice thinning of the skin at the bottom of the breast, which will allow you to more easily feel the breast implant.
It is good that you are wearing supportive bras as this prevent bottoming out from applying upward pressure to the fold at the bottom of the breast.
To correct “bottomed out” breasts, a surgeon would need to secure the implant in an elevated position and then reinforce the implant capsule at the bottom of the breast with a suture technique. There may be a need for Acellular Dermal Matrix, a soft-tissue graft, in the repair. A smaller implant is often advisable, if the original was too large. In fact, receiving an implant larger than indicated by your breast characteristics and boundaries increases the risk of malposition.
Please continue to have regular follow-ups with your surgeon to make sure your breasts are healing beautifully. Their recovery instructions should take precedence over all else you read here as they are better informed about your surgical details.
Hope this helps.