My left breast has bottomed out, resulting in great asymmetry. What can I expect for my revision surgery? (Photo)

Hello! My left breast was 350cc submuscular and my right was 375cc submuscular. A couple months in I noticed my nipples starting to rotate outwards and my breast dropped. What caused this? Is it from ingury? After revisiting with my PS, we decided on dropping the left breast to 325CC to further match size to my right breast and reposition the implant. What is recovery like and how successful is this? Thanks!

Doctor Answers 11

My left breast has bottomed out, resulting in great asymmetry. What can I expect for my revision surgery?

I am certain that you had significant asymmetry in your breasts before undergoing breast augmentation, and due to settling of the left implant this has been exaggerated.  With you in a face-to-face situation and with your preoperative photographs available one can plan capsulorrhaphy, right periareolar mastopexy and exchange of implants in an attempt to improve your asymmetry.  In a situation such as yours I think it is reasonable to explain that perfect symmetry cannot be expected but improvement should be sought.  Good luck and best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Correcting Asymmetrical Breast Implants by Adjusting the Breast Pocket

It's difficult to determine without 'Before" photos. Creating a #Neopectoral #pocket is sometimes used as a technique to provide a stronger more secure placement for breast #implants. In this case, the implant is removed and the capsule is dissected from the muscle to create a new or “neo” pocket for the implant. However, any #asymmetries regarding the folds under the breasts may not be totally corrected. To better determine the technique and placement best for your revision, I suggest you see your  board-certified surgeon to discuss in more detail.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

What can I do about asymmetry of breasts?

Your breast asymmetry may not be due to the breast implants bottoming out. You should get another opinion. Reducing the size will do very little to correct this! 

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews


Thank you for the question and the photos and you will need a pocket revision to obtain a more symmetrical appearance to your breasts as well as a possible implant change.  Be certain your surgeon has a lot of experience in this area as changing the size of the implant alone will not correct the problem.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Breast asymmetry

You can't correct your asymmetry by just dropping your implant size; you need to do a proper breast augmentation revision which will require you to adjust your implant pocket and decrease your medial lower breast pole prominence with an excision and will will require a mini lift on the right; to get your breast symmetric you need to have meticulous surgical planning and performance. Please see results below.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

Preop asymmetry?

It appears as though your IMFs are at approximately the same level  Given the appearance now, I would guess that you had significant asymmetry prior to augmentation.

Ethan Philpott, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 16 reviews

Revisionary breast surgery ( bottoming out) concerns…

I am sorry to hear about the complication you have experienced.   Based on the photographs, I agree that revisionary breast surgery will help. This operation will likely involve capsulorraphy ( (adjustment of the breast implant capsules) and breast re augmentation surgery.  You will find that postoperative "protocols" will vary. In my practice, I ask patients to limit upper body exercise for several months after this type of revisionary breast surgery.  You may find the attached link, dedicated to this type of revisionary breast surgery helpful to you as you learn more. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews


Hello and thank you for posting photos along with your question. Pre-operative photos would be helpful here to see what the asymmetry in your breasts were before the surgery. However, of the question is mainly about the left breast....It does appear to be bottoming out. This is a risk that can happen after breast augmentation. There are many ways to fix this and depends on the surgeons success with a particular procedure. Some will use the patients native tissue to recreate the fold and some prefer using special biological implants to assist with reconstructing the lower breast crease AKA the infra mammary fold. The surgery can be pretty successful...In my opinion, I have seen greater success with the use of a type of scaffold that strengthens the repair. Going with a smaller sized implant is a good idea because that will decrease the stress on the reconstruction. Hope this helps and wish you the best of luck!

Ankur Mehta MD

Ankur Mehta, MD
Sugar Land Plastic Surgeon
5.0 out of 5 stars 17 reviews

Implant bottoming ouot

Thank you for asking about your breast implants.

  • it does look as though your implant is bottoming out.
  • This can happen if the breast crease is naturally weak or weakened by surgery.
  • If by re-positioning the implant your surgeon means recreating the breast crease, the plan sounds a good one.
  • Making it a little smaller will put less stress on the breast crease and make bottoming out less like to recur.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

IMF disruption

Thanks for the great question and the photos. An implant typically bottoms out with the connective tissue attachments to the fold have been disrupted and not repaired during breast augmentation surgery. There are other issues which can make bottoming out more likely to happen, such as having a very large implant. The patients natural anatomy is unable so support the weight of the implant and it  moves.

If done properly, fixing a malpositioned implant should be pretty successful. There are a lot of different techniques which can be used to accomplish this goal. Without seeing you in person it is difficult to say exactly what may work best for you. The recovery from a revision surgery should be about the same or a little easier than the original surgery. Best of luck!
~Dr. Sieber

David A. Sieber, MD
Bay Area General Surgeon
5.0 out of 5 stars 31 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.