Are my implants dropping too low or bottoming out? (Photo)

Based on the photos it seems that your implants are slightly bottoming out. It’s not severe enough that you HAVE to do anything about it, but you certainly could. In terms of the cleavage, implants alone won’t give you clevage so a push up bra is typically still necessary. The implants give you more to work with and eliminate the need for padding but on their own will not create cleavage unless you have huge, very fake looking, extra high profile implants

Hi Heather 1222.  Based on your pics, I do agree that your implants are a little lower on your chest wall than what we like to see.  It happens.  I suggest you return to your surgeon and discuss this with him or her.  To start, If you were my patient, I would put a row of stitches in the bottom of each pocket to raise the implants.  If this doesn't work and the malposition recurs, then we would need to talk about using pig or human skin to support the implants but that is an expensive approach so I save that for only those who really need it.Best of luck to you.G. Robert Meger MD

Thank you for your question and photographs.  Your photograph indicates that you may have what is referred to as "bottoming out" of the implant wherein the implant falls below the infra-mammary fold.  Best to follow up with your plastic surgeon for an evaluation.  Good luck.

Dear Heather1222,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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

After reviewing your photos, it does appear that your implants have bottomed out. The only way to correct this situation is with revision surgery. The most common technique is removing the implant and repairing the capsule with sutures to bring the implant back up to the proper position. Another common technique used today, which, in my opinion, is more effective (but more costly), is removing your implant and implanting mesh support to reset your breast fold which holds your implant in the proper position long term. I recommend seeing your surgeon in person to recommend what the next step should be.

Thank you for your question.
It does appear that the implant have bottomed out. The only way to correct this procedure is with a revision surgery. This involves removal of the implant and repairing the capsule to elevate the implant back to the correct position. There are several techniques that can be used depending on your surgeons preference. I would suggest having an in person consultation with them to discuss what your next step should be. Good luck.

Your result looked very nice early on, but your implants have settled below your new fold.    It looks like your incision was initially located at the new fold, but in the later photo, you see that the incision in now well above the fold.     This is a common problem, especially when the original fold is lowered.     I can be improved by raising the fold again with/without mesh support.   

Thanks for your question. I suspect the beginnings of bottoming or an excessive lower pole stretch. I suggest you check with your plastic surgeon.Good luck. Dr. ALDO 

Thank you for your question,From your images, the implants did drop. However, cleavage is determined by the width of the sternal bone. To get a cleavage from breast implants, you would need really large, unnatural looking implants.Best,

Bottom Out means that the implant has shifted to the lower pole of the breast and is cosmetically unacceptable.  
In my practice I determine this by: 
Measuring the distance between the bra line (inferior mammary fold) and the areola (7 cm) Palpation of the lower pole to see if the implant is clearly palpable Determining if the nipple is pointing upward. 
Bottoming out is not necessarily from your implant pocket being made too large.  
It can be from the weight and size of your implants putting pressure on skin and tissues  The lower part of the capsule (pocket) can be closed , and reinforced internally with sutures. You can also have placement of an additional material to act kind of like a sling. 
There are two options to reposition the implants higher.  
The addition of acellular dermal matrix as an internal sling or bra is a good one but quite expensive.  The alternative that is several thousand dollars less is called an internal capsulorrhaphy, meaning tightening up the scar tissue capsule back to the original level of the breast fold (that position has been lost). In experienced hands that works over 90% of the time