Implant bottomed out 3 years post-op? (photo)

Question

I’m a 27F and I got under the muscle silicon breast implants three years ago. A couple of weeks ago the underside of my breast where my scar is started to be uncomfortable/tender and sometimes hurt, it has now moved up to being that way constantly and the area is bigger that is uncomfortable/hurt. Has it bottomed out?, my nipples definitely have become more uneven.

Finny George, MD · Answer

Hi, thank you for sharing your question. It’s difficult to diagnose the exact problem with photos alone but the implants seem to be malpositioned and this could be due to a number of things that may require surgery to correct, including a capsular contracture.

Donovan Rosas, MD · Answer

Post Op asymmetry is common and often is a function of the degree of pre-op asymmetry. Remember "sisters...not twins"

Bottoming out is a phenomenon which occur secondary to failure of the fold at the base of the breast. The fold can give way naturally (especially in the case of a large volume augmentation) or can be disrupted via surgical approach. The hallmark for bottoming out is an implant which falls below the crease. This can often times be noted by upwards migration of the fold access incision.

Based upon your photos, it is difficult to say for certain that you have bottomed out. Both scars lie slightly above the fold. However, this is only an issues if you have noted a change over time.

As always. discuss your concerns with a board certified plastic surgeon (ABPS).

Ted Eisenberg, DO, FACOS, FAACS · Answer

Always best to check with your surgeon, if possible, as your surgeon knows how you started and what was done. Otherwise, an in person exam by a plastic surgeon and a history of what was done is needed to answer your question. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., US

Daniel Barrett, MD · Answer

Dear ryms,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

From the posted photos it does not appear that your implants have bottomed out.  I encourage you to visit with your surgeon to discuss the discomfort you are feeling and the changes with nipple symmetry.  It could be anything from irritation from a bra, fragrance, etc to capsular contracture so it's best to be evaluated by your surgeon.

Ira H. Rex lll, MD · Answer

I cannot tell from the photographs at all what is happening.  You should probably see your plastic surgeon to help you through this new situation.  Good luck.

Implant bottomed out 3 years post-op? (photo)

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Answer: Asymmetry

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Implant bottomed out 3 years post-op? (photo)

Answers (8)

Answer: Bottoming out

Answer: Bottoming out

Answer: Asymmetry

Answer: Asymmetry

Answer: Bottoming out?

Answer: Bottoming out?

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Recommended reading

Everything you need to know about Breast Implants

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