Can bottoming out be fixed under local anesthesia?

I'm now 6 weeks post op 350 cc sub muscular with lowering of the infamammory fold. my left breast bottomed out right after my PS took out the stitches at 2 weeks post op. my PS said he can fix it in the office under local and I'll take something to calm my nerves an hour before. can it be fixed that easily? also at the fold of my right it feels ripple-y should I be concerned of this one bottoming out as well?

Doctor Answers 6

Breast Implant Bottoming out......?

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First of all, Bottoming Out can not be caused by removal of skin stitches.  It is a relatively common complication when one lowers the Infra-Mammary Fold.  Repair under local anesthesia is not a common choice.  It can be done under rib block anesthesia, but even then must be performed under the same sterility conditions as your original implant surgery.   Also recurrence is fairly common.  I normally recommend reinforcement of the repair using something called Strattice.   It's very expensive, but it works!

Good Luck!
Get a second opinion (in person) if you're uncomfortable.

Can bottoming out be fixed under local anesthesia?

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Thank you for your question and I am sorry to hear of your implant issue.  Bottoming out is best corrected under general anesthesia and as sterile conditions as possible.  Talk to your surgeon about his plans and review its safety.  If unsure of the answers you receive, seek a second opinion. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Breast augmentation

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Personally I wouldn't try and correct bottoming out under local anaesthetic. Usually one needs to place deep stitches onto the chest wall which can be very uncomfortable. 

Gary L. Ross, MBChB, FRCS
Manchester Plastic Surgeon
5.0 out of 5 stars 177 reviews

Redo breasts augmentation.

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Dear mghn,
 Front and side view pictures would have been very helpful to give you an intelligent and appropriate answer to your question.
Bottoming out does not happen from taking out skin sutures, so it is quite confusing as to what's going on with your breasts. 
 If by bottoming out you mean protrusion of the scar at the sub mammary crease, that can be easily repaired under local anesthesia. If , on the other hand you have double bubble or hanging of the lower pole, I would recommend full anesthesia for your comfort and for best outcome.
  Ask your surgeon to show you pictures of patients who had the planned procedure for you. That might put you mind at ease. However,  If no pictures are available, get a second opinion from  experienced board certified plastic surgeons in regard to your condition and it's repair.
                    All the best,
                                   Dr Widder

Bottoming out and revision

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I do not recommend having a breast revision to fix bottoming out under local only.  Best of luck.....

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Implant Revision Under Local Anesthesia

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There are many corrections, revisions, and touch-ups to breast augmentations that can be performed safely and comfortably under local anesthesia.  Fortunately bottoming out is pretty rare, but repair of the capsule and correction of the low implant can certainly be performed under local anethesia.  I usually have the patient take a light oral sedative, like Valium, about 45 minutes before.  It won't put you to sleep but will ease some anxiety.

Samuel Beran, MD
New York Plastic Surgeon
4.9 out of 5 stars 8 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.