5 months post op, smooth, round, 450cc saline implant. Are my Breast Implants Bottoming Out? (photo)

I am 5mths post op with smooth, round, 450cc saline implants placed underneath muscle. I am worried that my implants might be bottoming out because my areole placement seems high. When I raise my arms my areoles rise considerably...is it normal for the areoles to rise when lifting arms above the head? The areoles were mid breast mound right after my operation, but have risen as the implants settled. However, my crease incisions have not moved upward. I am wearing supportive underwire bras.

Doctor Answers 19

Early bottoming out after breast augmentation

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Yes it appears that your left breast implant is bottoming out. The nipple appeared higher because the implant has descended lower. The lower pole (between nipple and breast fold) has increased in length significantly compared to your pre op photo, even more so on the left than the right side. There are a lot of reasons for bottoming out after surgery. You need to find out the cause of the bottoming out before going through revision surgery. This allows a proper approach to have a successful revision. 

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Bottoming out

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From your photos it does look like your implants are bottoming out.  This would require revisional surgery to repair this either by suturing the capsule along the fold or reinforcing it with an acellular dermal matrix (ADM).  See your surgeon about this.

Leonard T. Yu, MD
Maui Plastic Surgeon

Are my Breast Implants Bottoming Out? (photo)

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Thanks for posting the photos. Yes you have a bottoming out effect. Only revisional surgeries can improve this issue. Sorry. 

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Capsulorrhaphy required to fix enlarged pockets

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Thank you for sharing your photos.

Based on the information provided in the post and without knowing the full details of your surgery, it seems that you are exhibiting enlarged pockets where the implants bottomed out hence the signs of superiorly placed areolae/nipples. Also, the form shown in the photos tend to support the aforementioned point of view.

At this point, I advise you to consider a revision surgery where the capsules will be internally sutured - capsulorrhaphy - in order to fix the ptosis.

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Breast Implants Bottoming Out?

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Yes, I think that  both of your breast implants are sitting relatively low on the chest wall and in relation to the nipple/areola complexes. It is probable that you are feeling the implants significantly along the lower poles of the breasts. Patients in your situation often complain of discomfort in the area of implant malposition. Also, as you have noted, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low.

 I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair).  This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly.

 I hope this helps.





Implant Malposition

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It does appear that your implants have settled low. This can occur because of various factors: the infra-mammary fold is released too aggressively at the time of surgery, the implants are too large for your frame and breast dimensions, aggressive implant displacement massage, gravity, and time. When implants are positioned low under your breast mound and not centered on the nipples, they can give the appearance that the nipples/areolae are high. This can also give the appearance that the nipples/areolae rise when the arms are lifted, as you have pointed out. At this point, wearing supportive underwire bras can possibly prevent additional downward displacement of your implants. However, the underwire bra will not reverse or fix the underlying problem. 

Thank you for your question. Best of Luck!

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 176 reviews

Are my Breast Implants Bottoming Out? (photo)

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Thank you for your question.

Your surgeon should be the best fit for answer.From viewing your photos, it does appear that you have bottoming out.There are a lot of reasons for bottoming out after surgery.He can fix your problem with a revision of your procedure. This should be covered by your surgeon also, but it really depends on him . Thank you again for your question .

Bottoming Out?

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   Your breasts have an overall pleasing shape, but they are bottoming out.  In addition, the breasts are very close together.  Pocket revision can be considered if you are unhappy.

Have your bottomed out?

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By the photos you provided, the answer is yes.  Hopefully your surgeon  has a revision policy that can help you with the additional costs that will be involved in improving your results.  Other doctors have mentioned viable options and you should discuss them thoroughly with your doctor.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Bottoming out (inferior implant malposition).

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Thank you for your post. I would agree that you are likely bottoming out with your implants. In addition, these implants look a bit too wide for you chest wall. Correction will likely need smaller implants and pocket revisions.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 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.