What causes your breast implants to bottom out?

Bottoming out is subjective. In certain cases the breast tissue is fuller on the bottom of the breast than it is on the top. Some patients like bottom fullness, and others do not. Different factors that can contribute to breast implants bottoming out would be over-dissection, loose skin, or extremely large implants. It is recommended to visit a qualified breast specialist to assess your situation, and provide a treatment plan to revise the issue. It is important to do your research to make sure the physician is experienced and qualified and is able to provide before and after photos to showcase their work.

Hello, bottoming out can happen due to the weight of the implants gradually stretching out the ligaments that normally create the crease under the breasts (inframammary fold). It can also happen during surgery if the ligaments are dissected excessively.

Hello,If the breast crease/fold underneath the breast mound is compromised for any reason, the implant could be pushed past this point and sit lower on the chest than intended. This can create the look of a "double bubble". Be sure to choose a board certified Plastic Surgeon who uses careful technique and can explain to you what the surgical plan is for you and risks/considerations. Choosing implants which are a reasonable size for your tissues and avoiding over-dissection of the creases during surgery will help reduce these risks.All the best

Dear Iwantboobs,The most common reason for implants "bottoming out" is violation of, or an anatomically weak lower breast fold.  Heavier, larger implants will tend to cause this more often.  Good luck!

Bottoming out can happen for a number of reasons. The most common include weak tissues along with heavy implants, wide implants much larger than a patients base diameter, and undermining of the breast fold.

"Bottoming out" of breast implants refers to the situation in which the implants move lower than we would like them to be.  That might mean that they are too low for where the nipples are, they are too low in their position on the chest wall, or some combination of the two.  Both of sides may be bottomed out, or only one of them could be.The main reason why this happens has to do with the anatomy and the way the tissues are structured in the part of the breast called the inframammary fold, where the breast mound attaches to the body wall at the bottom.  In the fatty layer under the skin there are two compartments, or layers, with a layer of fascia, or supportive tissue, running between them.  The uppermost layer, just under the skin, is firmer and has more support, while the deeper layer is flimsy and has very little support.  When the supportive fibers attaching this fascia to the muscle underneath are cut or weakened, the implant is able to move downward behind that supportive fascia into the loose deep fatty layer.  Thus, the implant sort of falls down behind the fatty layer along the muscle, and it appears too low.Many things can contribute to this situation, but in the end, the cause of bottoming out is the same:  the implant has lost its lower support and is free to move downward.  Thus, if the surgeon is repositioning the inframammary fold on purpose (sometimes we have to do that depending upon how your breasts looked preoperatively and the size of implants we are placing), or if it is weakened inadvertently, this can happen.  Also, larger implants can put more stress on tissues, and this can also lead to bottoming out.  Smooth implants are more likely to bottom out than textured implants because they can slide on the tissues more freely without friction.  Also strong muscle activity with the pectoralis muscles when the implants are placed under the muscle can push down on the implants and cause bottoming out.  This is why it is important to not only divide the attachment of the pectoralis muscle when placing implants underneath, but also it needs to be weakened a bit above the implant too in order to prevent unwanted muscle action.  This is also why most surgeons recommend that patients with implants under the muscle refrain from exercises that intentionally build up the pectoralis muscles, like pushups or bench press.Bottoming out can certainly be controlled and for the most part avoided by proper pocket formation and proper suture support of the deep tissues, as well as selection of the proper implants.  I hope this helps clarify the issue for you.  Thanks for the great question!

the underlying cause of all bottoming out is of course, gravity. since gravity cannot be prevented, there are other reasons some patients have this problem and others do not. The size (and therefore weight) of the implants used matters a lot. the bigger the implant, the better the chance of problems developing. Patient's tissues differ....some women have "stronger" supporting tissues (skin, ligaments, connective tissue) than others and the weight of the implants will stretch these tissues out to a greater or lesser degree. another factor can be the degree to which the surgeon disrupts the inframammary fold region during the surgery to place the implants....overdissection in this are can predispose to bottoming out .