Internal bra for bottomed out implant - is it necessary? (Photo)

Bottoming out will occasionally occur after aggressive treatment of capsules. This is probably more common after total capsulectomies. In retrospect, using an ADM such as Galaflex may have been helpful at the time of the capsule treatment. To now correct this condition, most surgeons would perform a capsulorraphy. An ADM is not always necessary as there will be some recurrent capsule present that could be used for the repair. I personally make this an intraoperative decision, i.e. I decide whether to use an ADM depending on the findings in surgery.

Dear aleedo,

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