I noticed that my nipples seemed really high when I lift both my arms. Is this normal or have my breasts bottomed out? (photo)

I got my breasts done 4 months ago. I had 450 cc silicone HP implants. Ive been freaking out all day because I noticed that my nipples seemed really high when I lift both my arms. Is this normal or have my breasts bottomed out??

Doctor Answers 12

Bottoming out!

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Dear March310, yes your breast implants have bottomed out more so on the left than the right side.  If you lift your arms it will accentuate the deformity so that doesn't make it worse.  Indeed, your bottoming out is very mild and a lot of patients wouldn't even notice it.  Patients with mild bottoming out such as yours often choose not to have correction because nobody will notice it.  It almost appears that your left nipple was originally a little higher than the right making the bottoming out more obvious on that side.  Bottoming out is specially common in thin girls like you and particularly common with saline implants since they are heavier.  It seems that smooth surface implants are more prone to produce this deformity so when I anticipate this problem I will choose to use texturized (fuzzy) implants because they seem to stay put and not drift.  Bottoming out is a lot more common when the implants are placed under the muscle than over the muscle because the constant action of the muscle pushes them down and out.  This problem is correctible in the hands of experienced surgeons because it takes a keen eye to return the inframammary fold to the correct location with accuracy.  I do this kind of correction all the time, sometimes in my own patients.  So don't freak out, it is fixable.  Maybe your own Plastic Surgeon is comfortable correcting it and won't charge you for it.  Dr Brou

Oklahoma City Plastic Surgeon

Bottoming out at 4 months...

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Your breast photos suggest early bottoming out of your implants. The best way to deal with this concern is to return to your plastic surgeon for an examination, post-op photos, and a discussion concerning your options.

If you can not tolerate the appearance of your breasts, the infra-mammary folds could be re-anchored surgically. A crease supporting bra is strongly recommended, with or without this surgery.

Best Regards,

Douglas J. Raskin, MD
Colorado Springs Plastic Surgeon
4.9 out of 5 stars 69 reviews

Have my breasts bottomed out?

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You must of been asymmetry pre operatively.. But you are on the border of "bottoming" Either learn to accept the OK result or have a difficult revision...

Bottoming out?

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Your implants may be bottoming out.  Best to be seen in person to be properly evaluated.  Call your surgeon to make an appointment.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Bottoming out

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Thank you for the photos and unfortunately your implants do appear to be too low relative to your nipples and I would go back to my PS and get his opinion. Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Your Breast Implants have Bottomed Out... :(

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Based on your photos, it does appear that you have malpositioned implants, left more than the right. Unfortunately, revision breast surgery would be required to improve the overall shape of your breasts and the position of your implants. Thank you for sharing your concerns and photos. Best wishes.

For additional information about Revision Breast surgery:

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 177 reviews

Bottomed out breast implants

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When the point of projection of the implant falls below the nipple, the nipple tends to look upward, and will rise upward when you raise your arms. This is indeed a low or bottomed out implant. You might have more trouble with bra or bathing suit as the nipple can show, a kind of wardrobe malfunction. If things progress and you have trouble with it a revision is possible.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Breast Implants and Bottoming Out

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Implants over 350 like yours are considered "big" implants and they are more prone to stretch and thin out the breast tissues. Your early pictures show ideal positioning so this does not appear to be  a surgeon error. There is no way to secure the implant internally to a rib or other tissue so the weight of the implant is borne by the skin ultimately. The term bottoming out refers to that stretching effect but there is no way to predict the degree of progression. Yours might not get any worse or they could continue to stretch out to the point that the nipple pops out of the bra or bathing suit. If things get to that point you may have to consider corrective surgery but I don't think you are at that point yet. You should support your breasts as effectively as you possibly can to help your tissues against the relentless force of gravity!

High profile implants and bottoming out

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Sorry to hear about your problem.  Unfortunately, it does appear that your implants are starting to bottom out.  HP implants (especially those over 350cc) tend to have that problem because the weight of the implant is more centrally located.  Be sure to discuss your concerns with your PS.  He or she may recommend that you wear a more supportive bra to try to slow this process down.

Bottomed out

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Thanks for your questions. I will say that the side view of your right implant  appears to be centered at the nipple. The left implant appears to be lower. That said, it is possible that your crease is lower on the left and that the nipple is a shorter distance from sternal notch to the left nipple. By raising your arms up, you slide your nipples up - that is natural -  and this can exacerbate the tendency for bottoming out. I'll also add that smooth implants also are impacted more by gravity and have a greater tendency to bottom out over time.

Peter J. Capizzi, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 93 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.