Have I Bottomed Out? I'm 6 Months Post Op. I Had a Lift and 380 Saline Implants. Do You Think They Just Settled? (photo)

I'm 6 Months Post Op. I Had a Lift and 380 Saline Implants. Do U Think They Just Settled ?

Doctor Answers 5

Breast Implant Bottom Out After Breast Lift

Thank you for your question.  Although your implants are lower than I'm sure they were right after surgery you do not have classic "bottoming out".  There is always some natural skin relaxation and sagging following a combination of breast lift and breast augmentation.  I agree with you that your nipple is slightly higher and the bottom or inferior pole of your breast is slightly lower than would be seen after a simple breast augmentation.

Hopefully the amount of relaxation that you're going to have has already occurred and the implant will not migrate further inferiorly.  Be certain to discuss your concerns with your surgeon.

If in the future the implants drop more a small revisionary skin excision can be done at the bottom of the breast to improve breast implant position.

This is not "bottoming out."

Your normal (genetic) skin elasticity gives your breasts a natural teardrop shape, and even with lift plus volume enlargement (implants), as tissues heal and scar tissue softens, your natural breast shape returns.

The skin removed is still gone, and your skin brassiere has given you a more uplifted and youthful appearance. No matter what kind of lift, sutures, or larger implants are used, this is how your tissues are, and your appearance right now is quite good (and that's without seeing how things were prior to surgery).

At this point in time, things appear to be healing appropriately, but your scars have not yet completely settled and matured, so your implants may also drop more (or not). I'd recommend a supportive bra most of the time, especially when exercising, and continue with avoidance of ultraviolet rays (sun OR tanning bed) to prevent or minimize permanent scar hyperpigmentation.

Kudos to your surgeon; you're doing great! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Have I bottomed out

It doesn't appear from the photos you provided that you have "bottomed out".  Your implants have settled and gravity has been working hard.  I agree that your breasts appear to be sitting lower than probably hoped.  To correct this you may want to talk to your surgeon about a mastopexy revision to tighten up the skin envelope or see what other options you have.  ac

Angela Champion, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 5 reviews

Have I Bottomed Out?

Just settled NOT bottoming out. Best to discuss this with your chosen surgeon to fully understand these terms.///

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Have I Bottomed Out after Breast Augmentation/Lifting Surgery?

Thank you for the question and pictures.

The pictures demonstrate your concerns nicely. Your breast implants do "sit" somewhat low on the chest wall. This is best demonstrated on your side view where the breast implants seem somewhat low, and the nipple/areola complex sits somewhat high on the breast mound.

Generally, terms such as “bottoming out” or “natural look” can be confusing. Suffice it to say that your breast implants do sit somewhat low on your chest wall and that, if the position/size of your breasts are of concern, revisionary breast surgery may be helpful to you.

This type of revision will likely include additional tightening of the skin envelope ( revision mastopexy surgery),  possible adjustment of the breast implant capsules ( capsulorrhaphy), and possibly adjustment of the breast implants' size/profile.

Patients who are considering revisionary breast surgery should select their plastic surgeon carefully; make sure that he/she can demonstrate significant experience with this type of surgery, achieving the goals you are looking for. Then, careful communication in regards to goals will be one of the keys to success. In my practice, I find the use of goal pictures very helpful during this communication process.


I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 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.