Worried About Bottoming Out. Can I Get a Full C or D With Smaller Implants? (photo)

5'5 135lbs, BF 1 child, looking for a full C small D. (currently 34 B deflated) PS Recom. 450cc HP Silicone, Worried About Bottoming out Can I Get These Reults with Smaller Impant? Is HP Right for Me?

Doctor Answers 9

Choosing the right implant

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Without an exam it is difficult to say which implant is best for you. Bottoming out can happen in some circumstances, especially with large implants.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Bottoming out and implant sizing

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Regarding "bottoming out": your lower pole does need to be filled out as in the second photo but this should be controlled and a lift effect created, although implants do not actually lift the breast. Causes of bottoming out include implants that don't fit and are too big for the space behind the breast, over-release of the lower pole issue, loss of control of the infra-mammary crease level, and stretch of the lower pole tissues. 

Bra cup sizes are, indeed, a poor way to measure breast size but in a 34 inch chest around you look to be at least a mid to upper B cup compared to other women with a 34 inch chest. Therefore, a properly fitted implant based on the width of your breast should increase your apparent cup size to a mid to upper C (low profile), borderline to small D (medium profile), and a mid to upper D (high profile). In silicone gel-filled round implants (Allergan or Mentor) these would be called different names but would still be lowest to highest profile scaled for the same diameter/width. 

Some plastic surgeons worry about bottoming out caused by larger implants but I haven't found this to be the case if the implant is sized properly, positioned properly, and healed properly in that position. Big feet don't "bottom out" a shoe if they are fitted properly to the shoe. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Bottoming out after breast augmentation surgery

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Thank you for your question.


"Bottoming out" is usually due to over dissection of the inferior pocket and not necessarily from medium sized implants. You should be able to achieve your desired 'look' from smaller  HP implants. Please make sure your PS places them under the muscle for extra support.

Kind regards,

Dr. H


Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

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Worried About Bottoming Out?

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Thank you for the question and pictures.

Based on your “starting point” and your cool pictures,  I think you will be able to achieve your goals with a properly executed breast augmentation procedure.  For sure, the incidence of true “bottoming out” is rare. Exactly what size/profile of breast implant will be necessary to achieve your goals cannot be determined without direct examination.

I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct compariso
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 

I hope this helps.

C or D with Small Implants

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Achieving very close results to the one depicted in photo#2 is very possible.

Usually, bra sizes are not that accurate so it is important that you seek a physical examination / consultation with a board certified surgeon of ample experience.


However, if you have a deflated 34B after physical assessment then you can achieve the size you desire with implants around 325-50cc (definitive size can be determined upon consultation only).


For the natural feel, I recommend a submuscular silicone implant.


Best of luck to you and thank you for sharing your photo.

Dr. Sajjadian


Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

B to D

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Dear worrier,

   It all depends on your chest and breasts circumference measurements. Obviously , it has to be done at the surgeons office because bra sizes are many times incorrect. If you are indeed 34 B , than to become a full C or small D you will need 225cc to 275cc. The recommendation by your surgeon of 450cc will bring you up to 34 DD.  Now, if your bra size is incorrect and you are small 34 B , than a 300cc or 350cc will do. You have to choose an experienced board certified plastic surgeon who is familiar with the measurement technique.

                 Best of luck,

                                        Dr Widder


Worried About Bottoming Out. Can I Get a Full C or D With Smaller Implants?

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Even with posted photos very hard to advise over the internet. 450 cc HP sounds OK but again need to be examined. seek in person additional opinions. 

You can have a great result with a smaller implant

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You can have a great result with an implant less than 450cc, which is at the larger end of the scale if a full C or small D is your goal. The HP implants are 'popular' right now however for many years we got along without them, or considered the rounder look much like a grade I capsule. A moderate to moderate plus could look just fine standing and laying back. The picture is a reachable goal.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Worried about bottoming out

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Bases on your pre op photo and goals, this size implant could provide the look that you want.  Bottoming out could result from poor surgical technique, lack of proper post operative breast support, or how your body heals. The first two variables can be controlled, but the last cannot...it is a risk with implant surgery, though a relatively small one, even at this size implant.

Leonard T. Yu, MD
Maui Plastic Surgeon

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.