Have my breasts bottomed out? My dr suggested a capsulorraphy, reusing my old implants. I want to change to silicone. (Photo)

Doctor Answers 4

About Breast Implants Bottoming Out

"Bottoming Out" is the term given to implant #displacement, where the implant drops down below the existing inframammary fold; the natural crease beneath your breast. This may occur when the fold has been released excessively during surgery or may be due to factors of the patient’s collagen and tissue integrity. The implants then sit very low on the chest with a lack of internal support for the implant itself.

Correction usually involves #restoring the crease beneath your breast to it's normal position with internal reconstruction of the capsule around the implant (#capsulorrhaphy). Sometimes a biologic fabric (Acellular Dermal Matrix or #ADM) can be used to attach to the breast tissue internally while supporting the implant.
This corrects the placement of the implant, redefines the breast shape, and also refines the internal fold.

To manage scars following the procedure, I suggest #scar maturation products to my clients. Such as BioCorneum or Embrace, to name a few, are recommended. But, it's best you wait a few weeks following your surgery, to begin using them and speak to your surgeon about healing concerns.


Orange County Plastic Surgeon
5.0 out of 5 stars 102 reviews

Revision of bottomed out breast implants with supportive sling of acellular dermal matrix

Yes a capsulorrhaphy can be done to elevate your inframammary crease and reduce the amount of bottoming out and you should be able to change to silicon gel breast implants.

Based on the fact that you've bottomed out so significantly discussed with your surgeon using a sling of a sagging or dermal matrix or SERI to support the breast implants and prevent further bottoming out.

Consider internal bra for bottoming out

The photos show significant bottoming out and likely some thinning of the tissues that support the implant. Although each case is different and there is no way to know without an in-person exam, it appears that you would benefit from an internal bra using SERI Scaffold, Strattice, or perhaps GalaFLEX mesh. There is no reason why you should not switch to silicone if you are willing to pay for new implants.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 51 reviews

Bottoming out of implants

Your photographs suggest that the implants are sitting to low.  However, this would really need to be determined by an examination with your surgeon.  If you want to change to silicone, you should.  At that time, the inframammary fold could be reconstructed and reinforced with an acellular dermis product (like Strattice or Alloderm) or other product.  Your surgeon should be able to discuss these options with you.

Todd C. Case, MD
Tucson Plastic Surgeon
4.9 out of 5 stars 55 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.