Is it the surgeons fault if a breast implant bottoms out?

is it the surgeons fault if a breast implant bottoms out? I know thin skin is more prone to bottom out but if it occurs from over dissection of the pocket, etc. shouldn't the surgeon fix it without charging the patient for the surgeons error. The patient should only have to pay for anesthesiologist fees.

Doctor Answers 5

Bottoming Out of Breast Implant

Bottoming out of a breast implant, manifested by the implant drifting below the normal lower border of the breast (inframammary fold) and thereby creating too much fullness below the nipple/areola, can have different causes.  It occasionally occurs even in the hands of a skilled surgeon performing the surgery appropriately.   For example, in someone with thin, tight skin and very small breasts who desires a pretty large implant, it may be necessary to dissect the space for the implant a little below the lower breast border (fold) in order to center the implant behind the nipple.  In such a case, there is increased risk of the implant weight stretching the lower breast skin over time, causing bottoming out.  I have successfully used a specific suturing technique to reinforce the lower fold and prevent this problem in most cases, but it is always a possible risk.  This is why I sometimes encourage patients with very tight skin and small breasts not to go too large.  My own personal philosophy is that if this problem occurs within the first year after surgery, then I will reoperate at no charge for my services but the patient will be responsible for anesthesia and facility charges.

West Palm Beach Plastic Surgeon
5.0 out of 5 stars 30 reviews

Is it the surgeons fault if a breast implant bottoms out?

Sorry to hear about your situation.   You have a great question.Bottoming out is a problem every surgeon has faced at one time or another.   Even in the best of hands and the perfect dissection there is a risk that the implants can migrate.   Fortunately it is not a common issue but it does happen.Each practice has their own policies on revision fees.   In my practice I will waive my fee but have the patient pay the operating room and anesthesia fee.    It is important to sit with your surgeon to discuss your issues and his/her policy on revision costs.

Jeffrey Antimarino, MD, FACS
Pittsburgh Plastic Surgeon
5.0 out of 5 stars 56 reviews

Is it the surgeons fault if a breast implant bottoms out?

I am sorry to hear about the complications you have experienced. Breast implant displacement problems, such as bottoming out, can occur despite the procedure being performed correctly.  When it comes to revisionary surgery costs,  policies will vary: charges such as facility, anesthesia fees and/or discounted or waived surgeon's fees are quite customary in most practices.Make sure that the plastic surgeon who does this procedure for you can demonstrate significant experience with this type of revisionary breast surgery.  Key will be:  your surgeon's experience level, careful execution of the procedure, careful attention to postoperative care/activity restrictions. I hope this, and the attached link (dedicated to corrective surgery for bottoming out concerns), helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,501 reviews


Most plastic surgeons performing breast augmentation are not trying to make the implants bottom out after breast augmentation.  There are some unpredictable part in surgery despite our best efforts.  Fortunately, your problem can easily be addressed under local anesthesia.Most surgeons have some revision policies.  I only charge for the facility and general anesthesia if needed.Best Wishes,Nana Mizuguchi, MD

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 51 reviews

Is it the surgeons fault if a breast implant bottoms out?

Not really your issue's elastic component might be very lax thus a bottoming effect could occur. BUT you failed to post photos! So best to seek in person PAID second opinions!

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 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.