Am i showing signs of bottoming out? What can I do to stop this from progressing? (photos)

Question

Am i showing signs of bottoming out? If so what can i so to keep it from progressong further?

Daniel Barrett, MD · Answer

Dear Fantastic68921,
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

Derek Fletcher, MD · Answer

You will likely need another surgery to remove the extra lower breast skin. Depending on the surgery you had and the time it took for your lower breast skin and tissue to stretch and fall, your surgeon may want to consider techniques to add support to your tissues to help prevent this from happening again or to slow the process and give you a longer lasting result. A detailed, in person exam and a review of your operative report are needed to determine the best plan for you.

Farbod Esmailian, MD · Answer

I would recommend you wear a good supportive bra as much as possible. I generally ask that my patients wear a sleep bra and wear a good sports bra when they are active and at all other times to wear a good support bra with or without wire as long the bra provides them with good support.

Hope that helps

Hope that helps

Camille Cash, MD · Answer

Yes, it does appear that the breasts are bottoming out.  It's difficult to stop this from progressing.  For correction a second reduction or lift is needed.  Mesh can be used to help support the tissues in an effort to prevent this happening again.

Connie Hiers, MD, FACS · Answer

Yes, you are bottoming out from the weight of the residual breast tissue. More can be removed using the inferior incision along with excess skin, or wear a really good supporting bra. Going smaller is the best choice.

Ersin Gonullu, MD · Answer

bottoming out deformity is sometimes seen after breast reduction and breast lifting surgery as well. mostly the reason is poor skin quality. and the only solution to fix this problem is to remove the sagging tissues and lift the rest tissue again. hope this answer help you. all good wishes

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note that your breasts are relatively symmetric and are of significant volume. The distance from the top of the breast bone appears relatively normal, but the distance from the nipples to the fold beneath the breasts is significantly increased. The nipples reside above the level of the fold beneath the breasts. There is significant loss of superior pole breast volume, and exaggeration of inferior pole volume. 
Your breasts have "bottomed out".
During pregnancy or in patients with large breasts, the breast skin is stretched by underlying tissues. Its elastic properties may be exceeded, resulting in rupture of the skin's elastic fibers and irreversible skin stretch. The inelastic skin will not configure or conform, resulting in sag. The damaged skin will be prone to further stretching. 
A further reduction of the infraareolar portion of the previous reduction mammoplasty will be required for correction as it will remove recurrent stretched out skin as well as excessive remaining breast tissue (to prevent another recurrence). Reinforcement of the repair can be accomplished with an absorbable mesh. 15% of cosmetic surgeries may benefit from revision. 
Revisit your plastic surgeon for evaluation and discussion.
Best wishes...

Am i showing signs of bottoming out? What can I do to stop this from progressing? (photos)

Answers (7)

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