I want to go from 375cc to 600/750cc - can my surgery scar and bottoming out be corrected? (photos)

Question

Why do Drs want to fix my bottoming out and high scar by pushing my implants up to my collarbones? Is there not another way of doing this revision and scar camouflage? Instead of pushing the scar in and creating a new fold can you move my current low fold up a few inches into my existing scar without forcing the implants to sit high? Just a small tuck at the current fold camouflaging my current scar by folding it a little. Scar doesn’t have to be completely hidden. Does that make sense ?

Connie Hiers, MD, FACS · Answer

First, you are bottoming out because your tissue is not supporting the weight of your implants. You need to go smaller, not larger. Second, the fold needs to be raised so the base is back into its original position. Mesh may be needed for support.  Implants do not need to go up to your collarbone, and this is not a normal look.

Gary M. Horndeski, MD · Answer

What is happening is that the weight of your implant is stretching the skin inferiorly and laterally and causing the bottoming out.  That is why the scar is now higher on the breast.  Adding larger implants will make the situation even worse.  At this time, I recommend reinforcement of the capsule inferiorly and laterally making the elevated pocket higher.  At the same time, it is also possibly to advance the inframammary fold up slightly higher.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear evangeline jamie,
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

Mats Hagstrom, MD (license on probation) · Answer

Breast augmentation outcomes are based on three variables.
The first is the patient candidacy for the procedure. The second is the choice of implants in regards to size shape and type.
The third is the surgeons ability to put the implant in the correct and atomic location.
 Your breast implants have bottomed out and this is most likely related to the size of implants and how the surgery was performed.
Using bigger implants is going to lead you down to a road of complications and more revision surgery.
If you use an implant that is larger than the natural diameter of your breast, the implant has to go somewhere.
I generally do not recommend opening the IMF or infra mammary fold. Opening the IMF is what causes the implant to bottom out due to gravitational forces and contraction of the pectoralis muscle.
This happens much more commonly with the use of implants that are larger than the natural breast diameter.
Your best course of action is to correct and reestablish the IMF in the correct position.
This will push your implant up towards your clavicle.
What you can do with your finger is not what happens after surgery.
There is no such procedure.
I would not recommend doubling the size of your implants.
You are already having problems with your current size implants and increasing the implant size is going to make the problem worse.
Correcting bottomed out implants is difficult enough as it is.
This type of revision is fairly complex and you should be highly selective regarding finding providers.
Anytime, patients opt for excessively large implants the chance of undesirable side effects, complications and need for revision surgery goes up dramatically.
Each time someone has revision surgery things become more complex and difficult.
The importance of having a long-term strategy without the need repeat revision surgery cannot be over emphasized.
I suggest you focus your efforts on finding a sufficiently experienced provider to guide you through the decision-making process and maximize the chance of having a revision that can hold up over time and not re-create the bottom out appearance. Correcting bottomed out implants with consistent long term success is not easy or straightforward.
Good luck,
Mats Hagstrom MD

I want to go from 375cc to 600/750cc - can my surgery scar and bottoming out be corrected? (photos)

Answers (4)

Answer: Breasts

Answer: Breasts

Answer: Revision

Answer: Revision

Answer: Bottoming out

Answer: Bottoming out

Recommended reading

Everything you need to know about Breast Implant Revision

Answer: What determines breast augmentation outcomes?

Answer: What determines breast augmentation outcomes?

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

I want to go from 375cc to 600/750cc - can my surgery scar and bottoming out be corrected? (photos)

Answers (4)

Answer: Breasts

Answer: Breasts

Answer: Revision

Answer: Revision

Answer: Bottoming out

Answer: Bottoming out

Recommended reading

Everything you need to know about Breast Implant Revision

Answer: What determines breast augmentation outcomes?

Answer: What determines breast augmentation outcomes?

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.