Am I beginning to bottom out??? Or is this part of the drop and fluff process?? (photos)

Question

The fold in my left breast had to be altered by my surgeon to correct some asymmetry. I have noticed that the lower pole of my left breast is about 1-2cm bigger/below the other and feels a bit heavier. I might just be paranoid but i feel like my nipple has moved a tiny bit more facing upward. My left breast also has a bigger implant (375) whereas my right has 350 cc. My implants are partials. What are the early signs of bottoming out?

Alejandro Nogueira, MD · Answer

Your surgeon did an excellent job, stay confident you are receiving a good attention, no issues so far.

Martin Jugenburg, MD · Answer

Your photos do not display bottoming out. In fact, you seem to have great results so far. Congratulations.That being said, I would like to give you some information to help you be attentive of signs of bottoming out as you did say one of the nipples has moved up a bit (a sign of bottoming out).
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.
Clinical signs:
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 to be
wearing supportive bras as this prevent further bottoming out. Supportive bras
will apply upward pressure to the fold at the bottom of the breast
Please continue to have regular follow-ups with your surgeon
to make sure your breasts are healing. Their recovery instructions should take
precedence over all else you read here as they are better informed about your
surgical details.
Hope this helps.

Charles Nduka, MD · Answer

Based on your photo your breasts are not bottoming out. They seem to be normal at this point and they are healing well. If you feel less assured you can consult with your surgeon regarding the issue, but it is still too early to say they are bottoming out.

Tom J. Pousti, MD · Answer

Congratulations on having undergone the breast augmentation procedure. Your plastic surgeon will be your best resource when it comes to accurate assessment, advice, and/or meaningful reassurance. There are many variables when it comes to how much breast implants will "settle";  the main variable in my opinion will be exactly how/where the breast implant pocket was dissected. Again, for this reason, your plastic surgeon will be your best resource.Having said that, your photographs do not demonstrate "bottoming out" of breast implants.
  
Generally speaking, breast implants will "drop" into the pocket that was created during surgery. The rate of breast implant "settling" may depend on factors such as size of breast implant pocket dissected, tightness of the overlying skin/muscle layers, and size of breast implant utilized.  Some degree of asymmetrical "settling" is commonly seen.   It may take about 6 months (for some patients longer) to see the final result.  As the breast implants "settle", the lower breast poles will round out, and the nipple/areola complexes will sit higher on each breast mound.
In cases where significant breast asymmetry persists, the pros/cons associated with revisionary breast surgery (for example, capsulotomy surgery for an implant that is sitting too high or capsulorraphy for a breast implant that is too low) should be carefully considered prior to making decisions whether or not to undergo further surgery. 
 Best wishes for an outcome that you will be very pleased with.

Richard P. Rand, MD, FACS (retired) · Answer

The photos don't look like bottoming out. The tapes on the incisions look to still be right in the creases. You should be wearing your postop bra 24/7 for 3 months to help to solidly heal the implants without letting them drop.

Am I beginning to bottom out??? Or is this part of the drop and fluff process?? (photos)

Answers (5)

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