Indent - bottoming out? (Photo)

Question

Noticed this indent on one breast 14 months post op. Subglandular implants. What do you think this is? Will it worsen?

Daniel Barrett, MD · Answer

Dear shadypalms123,
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

Connie Hiers, MD, FACS · Answer

You have a little thinness to your breast tissue there and the implant is sitting just behind that area. It may not get worse, but do wear a good supporting bra.

Camille Cash, MD · Answer

This may be the edge of the implant or wrinkling within the implant that you are seeing.  Visit with your surgeon to check the integrity of your implants.  Being able to see and feel the edges of the implant are more common in those with little breast tissue, subglandular placement, and with saline implants.

Mats Hagstrom, MD (license on probation) · Answer

Is difficult to tell from a picture alone.
If you can feel the implant, then it is mostly related to the texture of the implant.
Rippling is usually more palpable when using sailing implants than silicone.
It’s possible the amount of tissue covering the implant is quite thin in this area.
 There are multitude of variables that can contribute, including how the implant was placed.
Generally speaking, there are variables to determine breast documentation outcomes.
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 variable is the surgeons ability to place the implant in the correct anatomic location.
All three of these variables could be contributing.
 Generally when there are issues after breast augmentation surgery, the problem can usually be traced back to one or more of those three variables.
Quality assessment requires quality information in your case that probably means an examination with an in person second opinion consultation.
For second opinion consultations I suggest coming prepared bringing with you a complete set of proper before and after pictures and a copy of your operative report.
These should all be able to be obtained from your current providers office if you request them.
Best,
Mats Hagstrom, MD

Indent - bottoming out? (Photo)

Answers (4)

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