Should I Have a BA Revision to Treat Painful Bottoming out Before or After my Next Pregnancy?

1 Year ago I had Breast Augmentation/silicone 304cc mod plus unders. This Surgery has resulted in painful bottoming out that causes a constant pulling feeling &terrible burning sensation in my nipples! My question to you all is, I would like to have this repaired - but I would also love to expand my family ( I already have twins). On the plus side I experienced very little swelling, sagging when i breast fed the twins and I am young (30 yo), please give me your expert advice!! Thank you all..

Doctor Answers 6

Bottoming Out repair Prior to Pregnancy

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If a patient is experiencing pain and a pulling sensation in the bottom of the breast, and feels like the implant is pushing past its natural position ( bottoming out), then I recommend having it repaired whenever possible.  Whether someone has it before or after a pregnancy is really up to them.  However, if it is painful enough now to bother you on a daily basis, then I would have it repaired now rather than later.  With a pregnancy and the increased breast size that comes with it, that may add even more traction to the area and cause even more discomfort.  I hope this helps.

Pregnancy and breast augmentation

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I tell my patients that if you are planning on having children, it is best to wait until after the pregnancy to undergo breast augmentation/revision surgery. This is because the breasts do change with pregnancy and breast feeding. If you wait until after your pregnancy, then you may not require additional surgery whereas if you have the revision prior to planned pregnancy it is likely you will need additional surgery to improve the appearance of your breasts. 

Hope this helps. 

Margo Herron, MD
Medford Plastic Surgeon

Revisionary Breast Surgery Before or After Pregnancies?

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I think you will be best served waiting until after you have completed pregnancies, if these are planned in the near future, before undergoing revisionary breast surgery. Completing pregnancies first will help decrease chances that additional surgery will be necessary, secondary to the  breast changes that may occur during/after pregnancy.

 Correction of bottoming out of breast implants may involvecapsulorraphy techniques (internal suture repair of the breast implant pockets). This involves removal of a segment of breast implant capsule among the inferior/lower aspect of the left breast implant pocket. The 2 edges of  capsule tissue are sutured to one another. This procedure reduces the size of the implant pocket and prevents the descent  of the implants, keeping the breast implants in better position on the chest wall and keeping the nipple/areola complexes better centered on each breast mound.

You may find the attached link, discussing breast  implant displacement concerns, helpful to you.  Best wishes.

"Bottoming out" is seldom painful and can be done shortly before anticipated pregnancy.

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There's no problem getting your problem fixed by an operation if you plan to have a family the few months. An alternative approach would be to have the implants removed and then get pregnant. When breast-feeding is over you can then deal with the bottoming out which will be substantially corrected in any other aesthetic problems generated by the pregnancy.

Planning revision surgery of the breasts following pregnancy

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If you are planning a pregnancy in the next year then and have already had problems with the first augmentation then it would be best to wait until your body is in a stable condition.  You want to have the problem corrected and have a long lasting result.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Should I Have a BA Revision to Treat Painful Bottoming out Before or After my Next Pregnancy?

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You dont mention if you have saline or silicone implants.  If you have saline, and you know that you are planning to fix the bottoming out anyway, you may want to consider deflating the implants when you find out that you are pregnant, as your breasts will likely get larger and more pendulous during pregnancy, thus likely resulting in more pain.  If you have silicone, then you need to decide between 1) dealing with increased pain during pregnancy and re-doing the breasts after delivery 2) removing the implants and replacing after delivery or repairing the bottoming out prior pregnancy with the knowledge that you may still have enough changes from pregnancy that you may need additional surgery regardless.  Good luck with your decision!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 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.