Is My Revision for Bottoming Out Also a "Botched Job"? (photo)

I had an augmentation 9 months ago. The left bottomed out. Not much, but enough. I'd lost faith in my original surgeon so I hired another to do the revision 3 months ago. Well, surgeon #2 raised the left side so high that the result is now worse than what Dr. #1 had done. Dr. #2 says to "wait for it to drop." I don't believe that a fold can lower itself, no matter how long I wait. Can it? Do all of you surgeons peddle this "wait and massage" as a delay tactic to shift onus onto patient?

Doctor Answers 8

Healing takes time

Wait and see means exactly what it is.   Healing takes time.  Healing is different for each individual. At 3 months there is still a possibility that your high implant position will improve. Give it more time. If no results in 6 months you may need to consider an inferior capsulectomy. 

Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Results of Breast Augmentation Surgery " Botched”?

No,I do not think that surgeons use the “wait and see” as a tactic.  It takes time ( for several months at least)  to see the end results of surgery. There is no immediate gratification. Patients should also be aware that absolute symmetry/perfection will not be achieved despite best efforts.  What you are calling a “botched job”  may be the best result that could be achieved in your situation.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Is My Revision for Bottoming Out Also a "Botched Job"?

Only showing the postop photos following the second operation makes it very hard to comment. Please post befores and preop after 1st operation so we can determine exactly what is going on. No I do not believe the infra mammary fold will drop. No we do not "peddle" any delaying tactic to the patient. To me your result is acceptable but the left appears slightly smaller. I feel an increase of 50 cc's to the left could help. But need to see the other photos. 

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

Do breast implants drop over time?

It is not unusual during a revision surgery for breast augmentation to overcompensate the elevation of an implant that is too low with the expectation it will drop with time.  There is no doubt that saline implants drop more over time than silicone implants.  Massage will help to lower the implant in the pocket.  However, even a minor capsular contracture can elevate the fold and give excess superior pole fullness. 


Photos do not give as much information as a thorough examination.  Certainly, six months is a reasonable amount of time to wait prior to final evaluation of implant position. 

Glen Brooks, MD
Springfield Plastic Surgeon
4.9 out of 5 stars 9 reviews

Your breasts shape will not change much and your revision is not botched

Your before picture would help. Your implants are too big for your breast tissue and your lower pole could not stretch much and imants expanded your upper pole and pushing the nipple lower. You could have another revision and use smaller imants and lower the implants. I would suggest that you send your before surgery picture for better evaluation. 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 124 reviews

Is my revision Botched?

I would tell you to be patient, breasts that are augmented change over the post-operative period for well over a year, I feel that your repair looks great for three months as your breast will stretch over the next few months and your lower pole will begin to match the lower pole of your other breast, be patient and massage!

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 87 reviews

Repairing bottoming out

Repairing a bottoming out situation often requires the fold to be lifted and the pocket treated inferiorly.  It may stretch a bit over time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Waiting for settling

some surgeons may use the "wait and see" as tactic.  however in your case, one might expect settling to occure still.  three months is relatively early.  you might see a combination of the fold "lowering" a little and stretching of the lower pole.  with that the implant may drop some.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 58 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.