Have my implants bottomed out? 6 months post-op (Photo)

Question

I had implants just 6 months ago. I feel like they’re sitting low. I have very little upper pole fullness. Am I being crazy? Or have they “bottomed out”

Semih Yildiz, MD, FEBOPRAS · Answer

In the photos, the implants do look somewhat low-set with limited upper pole fullness, but a photo alone cannot confirm true bottoming out. Bottoming out usually means the implant pocket or inframammary fold has stretched downward, often making the nipple look relatively high on the breast mound.

At 6 months, some settling and loss of upper pole fullness can be normal, but if the position is progressing or bothersome, you should be examined by your surgeon. If true bottoming out is present, correction usually requires a revision such as tightening the lower pocket, reinforcing the fold, or changing implant/pocket details rather than massage or exercises.

Daniel Barrett, MD · Answer

Dear Raindrop26,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Vickram Tandon, MD · Answer

Over time, the swelling of the pectoral muscle resolves and the implant settles as the capsule around the implant matures. It is difficult to assess whether your implants have bottomed out, but I would recommend discussing with your surgeon if the breast aesthetic does not meet your goals.

Camille Cash, MD · Answer

From your photos it appears your implants are beginning to bottom out.  Some signs of this are the nipples shifting to an upward direction and an increase in the lower pole.  A surgical revision can correct this.  Sometimes mesh is recommended to support the tissues.  See your surgeon to learn more.

Connie Hiers, MD, FACS · Answer

Yes, your implants have bottomed out from the weight on your tissue. They are somewhat heavy for your frame and tissue. do wear a good supporting bra. Please discuss your concerns with your surgeon.

Mats Hagstrom, MD (license on probation) · Answer

It does appear that your implants of bottomed out. This sometimes happens after mastopexy surgery with or without implants. It’s more likely if the implant is not properly covered by pectoralis muscle.
It’s important that the implant pocket is designed correctly to minimize the chance of this happening.
Follow up with your provider and talk to him or her about doing a revision.
Revision surgery is not all that uncommon after augmentation mastopexy surgery.
Best,
Mats Hagstrom, MD

Have my implants bottomed out? 6 months post-op (Photo)

Answers (6)

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