How Quickly Does Bottoming out Usually Occur? Is the Breast Secure Once the Capsule Has Formed?

Large Implants due to their weight, gravity, thinning of tissues, chronically not wearing a bra, loss of elasticity and other factors may cause continued stretching so that your breast implant is no longer supported in its ideal position. This results in the progressive lowering of the inferior breast crease (inframammary fold). When the implant moves South to an undesired inferior position it results in the loss of volume and flattening of the upper pole of the breast, too much volume at the lower pole, increasing the distance from the fold to the nipple and finally the nipple position being abnormally high ( pointing up) and not centered. Similarly, the pocket can also stretch to the side (lateral) so that when lying down your implants fall towards your arm pits or sides, causing the “Side Boobs” appearance.Bottoming out and Side Boobs Contributing Factors:Larger/Heavier ImplantsImplants placed above the pectoralis muscleChronically not wearing a bra when uprightOver dissection of the Implant PocketSmooth ImplantsLarge swings of weight including pregnancySkin and soft tissue laxity, loss of elasticity

Bottoming out refers to excessive stretching of the skin and breast tissue of the lower part of the breast essentially from the nipple level to the level of the inframammary fold.

This will occur more in patients with poor tissue elasticity and in patients with larger implants which tend to weigh more and put greater strain on this tissue.  It is important to wear a well supportive, preferably underwire, bra after a breast augmentation to help support the weight of the implant.

The scar capsule may or may not help to support the weight of the implant.  Sometimes the capsule is quite thin and does not offer much support and in some cases the capsule is a bit more substantial and will support some of the implant weight.

Another case for choosing a more conservative size implant.

Thank you for your question.

Thank you for the question.

Generally, breast implants will fully “settle”  and be in a stable position anywhere from 6 months to one year after surgery. Generally, if implant  malposition ( Including bottoming out)  is going to occur,  patients will see it within this time frame.

In the longer term, breast implant malposition is still possible.  This may be related to the effects of time, gravity,  skin elasticity issues, weight gain and weight loss, pregnancy...

Fortunately, breast implant malposition  issues can often be corrected with  capsulorrhaphy techniques.

I hope this helps.