Is left bottoming out? (Photo)

Question

1 year postd op 325left and 385 right. Discomfort and tightness above left breast. Felt like I pulled or strained a muscle a few times. Also discomfort on bottom of breast too especially with no bra. Right side is high but feels ok.

Tania Najar, MD · Answer

Instead of bottoming out, this appears to be more of a capsular contracture case. I suggest seeing your surgeon for an accurate review.

Sean T. Lille, MD · Answer

Your result looks very nice. You have two very different breasts. That is a significant size difference between the two implants. Your left breast is just lower on your body than your right breast is and although your volume seems symmetric the size difference of the implants will magnify other asymmetries.  Discuss with your surgeon the discomfort you are having if it continues after trying a course on anti-inflammatory meds. Unsupported breasts can be heavy and cause discomfort, so always support them well.  I don't see any signs of "bottoming out" which would cause you to look flatter above your nipple/areola and your nipple would be pointed more upward.

Daniel Barrett, MD · Answer

Dear Peaceful602151,
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

Shana Kalaria, MD · Answer

Yes, the left side appears to be bottoming out. If it is painful, you may have a capsular contracture as well. It is best to see a board-certified plastic surgeon in person for an evaluation. Good luck!

Camille Cash, MD · Answer

At one year post op you are fully healed. The issues you are having can be corrected, however surgical intervention is needed to do so.  Visit with your surgeon for an evaluation.

Connie Hiers, MD, FACS · Answer

Yes, you are bottoming out from the weight of the implant. this can be fixed and you may need an internal bra with mesh for better support. Please do not go larger.

Olivier Deigni, MD · Answer

Hello and thank you for your questions and your pictures. A physical examination is needed to verify the softness of your implants and the implant pocket. It is difficult to tell whether you are bottoming out or developing some capsular contracture without knowing what your preop and immediate postop results were. I recommend that you follow up with your surgeon so that they may examine you and discuss what may be going on. Best wishes!

Derek Fletcher, MD · Answer

Yes, your left breast implant is sitting low which is causing the shelf on the lower pole of your breast. You should discuss this with your surgeon. You will likely need a revision surgery on the left side.

Richard R. Orr, MD · Answer

Yes, at one year, your implants should be level and symmetric at the inferior pole. Not only is your left implant sitting low at the bottom, it is lower at the top of the breast as well, which will affect the appearance of your cleavage. I would check back with your operating surgeon and see what can be done to fix this.Good luck

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and photographs.

I do see the difference on the left side which you mentioned.

What you are seeing is possibly a double bubble on the left side indicating that the implant has dropped down below the level of your breast tissue.

If you do have a double bubble surgery is required to correct it.

See your surgeon for examination in proper diagnosis.

Is left bottoming out? (Photo)

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