Bottoming out? 695cc Sientra HP. Dual plane. No lift. (Photos)

I'm 3MPO and wondering if my Right implant has begun to bottom out. I went with 695 after initially wanting 500cc. My PS said that my breasts wouldn't sag with that size. But they look huge and heavy, not beautiful anymore. They are so far down my chest when I'm braless, it's unattractive. My left crease was lowered and that breast has a cone-like shape now, but I'm more worried about how droopy they are. Muscles were lifted at sternum.

Doctor Answers 7

Bottoming out?

Aloha and sorry about your concerns.

It's hard to say for sure from the photos, but these implants do seem a bit big and are sitting low on your chest. Lowering the fold significantly can contribute to bottoming-out. Wearing a good support bra 24/7 may help.

You may want to return to your PS to consider smaller implants, possibly with a lift &/or internal mesh support; or seek a second opinion from an experienced board certified plastic surgeon for an in-depth consultation to review your options.

Mahalo and best wishes,

Dr D

Oahu Island Plastic Surgeon
5.0 out of 5 stars 31 reviews

Bottoming out with 695cc implants, dual plane and no lift

It does appear that you do have some bottoming out of your right breast.  It's one of the long term risks of breast implants unfortunately.  Risks factors for this condition usually include:  excessively large implants, weak soft tissue support (of breast skin envelope, muscle and inframammary fold), over dissection of inframammary fold/ lowering of the fold (for patients who need it for proper placement of the implant) and/ or not supporting your breasts adequately with a good support bra following surgery and/ or engaging in high impact activity (bouncy motions) too soon after surgery (and without wearing proper  support bra).  The surgical procedures typically used to correct this condition include either a capsulorrhaphy or using acellular dermal maxtrix tissue to form, raise and reinforce a new inframammary fold.  Sometimes fat grafts can be used to hide mild creases there if the implant and breast pocket does not need to be raised.

I would also agree that your breasts are sitting too low on your breasts.  Without seeing your before pictures, I would not know whether this was already a pre- existing condition and/ or it was made worse by lowering the fold and using large implants (it's usually a combination of both).  Typically the position of the base of your natural breasts (and it's "footprint") cannot be changed much with breast implants.  We just have to work with what you have (and have to accept the fact that it cannot be raised significantly to give you significant upper pole fullness) as their are always limitations with what we can do.  The position of your nipples/ areola can be raised with a lift procedure and the over- all shape can be improved.  A vertical scar/ lollipop scar lift can raise the inframammary fold a little.  Looking at your pics, that would be lift that I would recommend for patients with similar issues.  

I would recommend you see your plastic surgeon to discuss your concerns and find out what options you have. Best wishes.

Bao L. Phan, MD
Honolulu Plastic Surgeon
5.0 out of 5 stars 48 reviews

Implants bottoming out?

Sorry to hear about your problems after undergoing breast augmentation.  From some of your pictures it does appear that your right implant is bottoming out.  695cc implants are very large and your tissues may not be able to support such large implants.  You may need to undergo a revision to possibly switch out to smaller implants and/or re-enforce the inferior pole of your breast with internal sutures or an acellular dermal matrix.

You should follow-up with your original surgeon, assuming they are a board-certified plastic surgeon to review your options or seek a second opinion.

Jeff T. Healy, MD
Oahu Island Plastic Surgeon
5.0 out of 5 stars 104 reviews

Is Implant Bottoming Out at 3 Months


1.    pain is variable

2.    it takes 2-3 months for implants to settle and muscles to relax

3.    celebrex, motrin, and muscle relaxers can help

4.    massage and stretching may help

5.    everyone heals differently

6.    4-7 days off from work is common

Since it is 3 months into your healing process there is possibly more time to be allowed for complete settling of your implants. You should know that sometimes when it comes to the placement of implants a lift can be helpful to ensure that they do not sag. However, if you are concerned or worried at all you should visit your surgeon to have the area examined to make sure that healing is progressing well. Good luck.

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

Bottoming out? 695cc Sientra HP. Dual plane. No lift.

Thank you for your question.  You have very large implants, and large implants tend to drop  more than smaller implants.   My suspicion is that the look the to hope to achieve might require smaller implants and a breast lift.  Please follow closely with your plastic surgeon.

Bottoming out? 695cc Sientra HP. Dual plane. No lift.

I am sorry to hear about your concerns. It is difficult to know whether you are experiencing a breast implant displacement problem or whether you would have benefited from breast lifting/breast augmentation surgery, possibly with smaller implants, initially.  In other words, did you and your plastic surgeon elect to use larger breast implants (than you would have used otherwise) in order to avoid the need for breast lifting?

 I would suggest that you follow up with your plastic surgeon and discuss your concerns/goals. Hopefully, working together you will come up with a plan to achieve an outcome that you will be happier with. Best wishes.

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

That is a huge implant!

there are so many factors that need to be taken into consideration when choosing breast implants. From the looks of it, you are not an overly tall woman. Giant breasts will sit lower on your torso, robbing you of your waist. You lose your figure and it makes you look heavier than you are. Yes, I think your implants are too big. I would certainly  recommend a smaller implant with either a lift or breast reduction someday.  You can go back and talk to your original surgeon, but I have a feeling that he will think that you look great.  Giant breasts are not youthful.  I'm sorry that you were talked up in size for your original implant. Something much more conservative should have been done. Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 15 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.