Bottomed Out implants, how would you correct this? (photos)

12 yr old implants bottomed out After breastfeeding 3 babies. I have very little tissue & thin skin. I want smaller implants & to correct the bottoming out. What is the most cost effective way to fix this. I originally wanted the implants out all together but after seeing my recent mammogram pics I see I have no tissue left. I'm 34 my doc sent me for a mammogram after feeling a lump which turned out to be my implant valve

Doctor Answers 3

Strattice internal bra to correct bottoming out with thin coverage

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With the very thin tissue coverage you have, even smaller implants will not be ideal so internal support and coverage is needed. Strattice adds good support and implant coverage. Unfortunately it is not inexpensive but not as much as re-operating for a procedure that didn't work out.

Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Bottomed Out implants, how would you correct this?

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I am sorry to hear about the complications you have after breast augmentation surgery.   Although good advice would require in person evaluation, it sounds like you will benefit from a well executed capsulorraphy plus/minus  the use of additional supportive material such as acellular dermal matrix or biosynthetic mesh. 

The “internal bra” refers to a procedure where the breast implant capsule is utilized ( the procedure is called a capsulorraphy) to prevent the breast implants from moving too far downward or to the sides. Sometimes, the use of additional material such as acellular dermal matrix or biosynthetic mesh, may be helpful for additional support. 

Ultimately, careful selection of plastic surgeon,  appropriate selection of  type of revisionary breast surgery,  skillful execution of the procedure, and careful attention to postoperative activity restrictions will be key to success. You may find the attached link, dedicated to bottoming out concerns, helpful to you as you learn more.   Best wishes.

Revision augmentation

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I would need more information to answer your question accurately, including whether you have saline or silicone implants, how many ccs you have, whether your implants are over or under the chest muscles, etc.  Overall it looks like you would benefit from implant downsizing and lower / outer pocket tightening to reposition your implants, as well as possible reinforcement with a material such as Strattice.  If you have saline, I would definitely recommend changing to silicone and I often recommend preoperative deflation of saline implants (removing the saline at the office with an IV needle) to allow the skin to shrink before the revision surgery.  If you are over the muscles I would change you to under, and if you are already under I would consider creation of a new, better positioned pocket using a technique called a "neo-subpectoral pocket" creation.  This is a deceptively challenging surgery and although you have a lot of room for improvement, you need to make sure the surgeon that treats you has a lot of revision experience. To answer the cost effective part of your question, "cost effective" is a relative term.  Sometimes a more expensive surgery up front (such as using reinforcement materials) will be more cost effective by reducing the risk of needing further revision surgery in the future. Don't skimp on quality, because each revision surgery will get progressively more challenging so fixing things properly up front is critical.  Good luck! 

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 58 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.