Am I showing signs of bottoming out? (Photo)

Dear scrollinginsecret,
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

Thank you for the question. From the pre op pictures, it is evident that nipple positions are asymmetric and IMF is higher on left. It will be use full to see operation notes and early post op pictures if infra mammary fold has dropped or has there been increase in nipple to IMF distance. Are the implants behind the muscle or behind the breast tissue ? Without looking at pre op picture, it appears to have bottomed out on left , but it needs to analysed with more detailed information.

Thank you for sharing your before and after images. It does appear that your left breast has suffered some mild bottoming out leading to a high-riding nipple appearance, lengthened nipple to breast crease distance and the lower pole implant demarcation. Unfortunately surgery would be required to attempt to correct this.

You do show asymmetry of the folds in your preoperative photos but it does appear that you are beginning to bottom out. Visit with your surgeon to discuss your concerns. Surgery would be needed in order to correct this.

Yes, both are bottoming out, one a little more than the other. Being on top on the muscle, only your breast tissue which has been stretched and thinned from the implant is supporting the weight of the implant. do wear a good supporting bra now. You can have the pocket tighten with possibly adding the mesh, or place the implants behind the muscle for better support and tighten the pocket..

Most peoples left breast sets higher on the chest wall than the right. This is true for both men and women. And most individuals. The left inframammary fold is about half an inch higher than the right side. This appears to be true for you as well.
Your immediate postoperative result, shows your left inframammary fold having been lowered to some degree. It appears that you’re now bottoming out more on the left then on the right.
This will likely continue to get worse unless you have it addressed with revision surgery.
Correcting implants that are bottoming out is difficult, and isn’t best done sooner rather than later.
To minimize the chance of the condition happening again and again the repair for this needs to be done correctly.
Try to find a local plastic surgeon who has extensive expertise with breast implant surgery and has a proven track record correct thing bottomed out the implants.
The following are some general guidelines for finding the best plastic surgeon.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures.
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs.
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures.
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD