I'm 53, 122 lbs. Had an arm lift with breast augmentation 11/29/12. Have my Breasts Bottomed Out? (photo)

Hi, I'm 53, 122 lbs. Had an arm lift with breast augmentation 11/29/12. Skin has poor elasticity. Implants are 375 ml (lt) and 400 ml (rt) SRHPG. Jan 3013, apparent that my lt breast had been over-dissected. 2/13 I had a revision. Becoming painful (2-3 on a scale). Shorthand: Pressure. Wear bra 24/7 necessary. Weight of implants (both)=uncomfortable. Lt developing cone shape 1" from areola. Uniboob look if not shaken into place. Moving to Vegas. Will look for another PS there. Thank You!

Doctor Answers 6

Breast implant displacement

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There is bottoming out of the implant and the inframmary fold is also displaced inferiorly. I think a detailed assessment is required to know where was implant initially placed sub glandular, sub muscular or dual plane. Obviously at this point the implant seems to have a veery thin cover. I think replacing the implant ? Slightly smaller with reconstruction of infra mammary fold and reinforcement using the existing capsule or alloderm would give a long term stable result.

Dubai Plastic Surgeon
4.5 out of 5 stars 24 reviews

Correction of Breast Implant Bottoming Out

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You have experienced some bottoming out and that can be difficult to fix without adding some form of allogeneic dermis in thin skin with poor elasticity. You have experienced that given your one revision already. Given your level of low grade discomfort, you are probably headed for a more definitive revision in the future.

Have my Breasts Bottomed Out?

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Seems like you are going to obtain a new PS in Las Vegas who can examine you and recommend additional surgery. 

Have my Breast Implants Bottomed Out?

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After reviewing your pictures, it does seem to me that your breast implants do sit low on your chest wall. This positioning of the breast implants, makes it seem that your nipple/areola complexes are sitting relatively high on your breast mounds.

 Sometimes, patients with breast implant displacement problems, do experience discomfort in the area of breast implant displacement, presumably because of pressure of the breast implants on the under surface of the skin.

 It is likely that you will benefit from revision breast surgery. This will likely involve capsulorrhaphy, possibly with the use of acellular dermal matrix.

 I hope this, and the attached link (demonstrating many examples of similar situations), helps.

Bottoming out of breast implants can be corrected with Alloderm.

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You definitely have bottoming out.  In view of your history, I would definitely recommend reinforcing the next repair with a sheet of Alloderm to strengthen the folds.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Implant descent

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It does look like the implants are a little low on you.  Could be either pocket expansion, or lower pole stretch - can't tell from the tiny photos.  This could be revised surgically if it bothers you.  If you are having symptoms of pain or pressure, that suggests pocket expansion - and a capsule plication, possibly with Strattice, may be helpful.  Seek out a PS with lots of experience in this sort of repair.  Best wishes!

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