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

Question

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??

Peter J. Capizzi, MD · Answer

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.

Larry C. Leverett, MD, FACS · Answer

The unspoken variable is in the pre-op photos. When a patient presents with nipples that point upwards in the un-operated upon breasts, she should be told that the implants are going to look to low post op. This is because the nipples move opposite the direction of the implants in the final result. When the implants are too high, the nipples appear low. And when to nipples tilt upward pre-op (as in this case), the implants will look low post-op. The mild nipple asymmetry is likely a pre-existing phenomenon that is very prevalent (and would be seen on a pre-op frontal view) as is the elevation of both nipples when the arms are raised.     Be sure to minimize weight lifting/push ups etc., which force the implants down and out e.g. it makes them more likely to bottom out.

Mel T. Ortega, MD · Answer

Thank you for your question. I will need to ask for pictures to give you a better answer . But in any case your surgeon should be the one fixing 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 .

Juan A. Brou, MD · Answer

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

Darryl J. Blinski, MD · Answer

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...

Steven Wallach, MD · Answer

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

Peter E. Johnson, MD · Answer

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.

Victor Ferrari, MD, FACS · Answer

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.

Frederic H. Corbin, MD (license restricted) · Answer

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

Douglas J. Raskin, MD (retired) · Answer

Greetings,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,

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

Answers (12)

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