Is my right breast bottoming out? (Photos)

Question

I am 11 months post op and i cant tell if im bottoming out on my right side or just a slight bit asymmetrical. Please help!

Nelson Castillo, MD · Answer

THank you for sharing your question and photographs.  Your implant is unfortunately bottoming out and will require a revision procedure to correct.  Talk to your surgeon about appropriate timing.

Chul Hwan Seul, MD, PhD · Answer

Thank you for your question. On the side of the tattoo, there is a slight bottoming out. By performing revision surgery and moving the implant, we can achieve the symmetry, but since the asymmetry isn’t severe it is for you to decide if you want to get the revision. Now your implants are inserted over the pectoralis muscle (subglandular), but changing their placement to subpectoral or dual plane and performing fat graft would make implants contour less visible.

John Michael Thomassen, MD · Answer

Yes, you may need to support this side with a capsulorrhaphy.  I would also consider fat grafting around the breasts to improve the overall contour of the upper poles.

Martin Jugenburg, MD · Answer

Hello, this is a potential risk with any implant. Typically I prefer the submuscular method, so that the pec muscle can help support the weight of the implant. Over time with gravity the skin and muscle weaken. I always advised good supportive bras.

Irena Karanetz, MD · Answer

Hello,
Thank you for the question.
Based on your photos, it does appear that your Left breast implant has dropped (bottomed out) more than the right breast implant.
I would encourage you to discuss your concerns with your Plastic Surgeon. Sometimes, revision surgery may be needed to correct the breast asymmetry and to reinforce the breast fold further.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Jonathan Heistein, MD · Answer

Hi.  From your pictures, it does look like your implant is bottoming out and slightly lower than the other side. It is difficult to give you an accurate assessment without an in person consultation. You should talk to your surgeon about your concern, since he/she should be able to evaluate the issues and help you determine the best solution.  Best of luck!

Alan Gonzalez, MD, FACS · Answer

Hello @cahillwed2019 thank you for your question. I understand your concern, however without a proper assessment an expert opinion is not possible. The best course of action is to consult one or several board certified plastic surgeon for more information. Best wishes! Alan Gonzalez MD FACS

Daniel Barrett, MD · Answer

Dear cahillwed2019,
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

Camille Cash, MD · Answer

Yes it appears you are bottoming out.  This is likely due to the implant being too large for your breast space.  You may want to consider downsizing the implants for a better fit and to avoid the occurrence.

Scott Kreitzberg, DO · Answer

Great question. Based on the photos, the left your breast implant appears to be sitting lower than the right implant with a high appearance of the nipple, thus indicating bottoming out. This can be corrected with modification of the breast capsule. In some cases, an internal bra (absorbable mesh or ADM) can be used to further support the implant and avoid recurrence of the bottoming out. A board certified plastic surgeon can help you decide the best option for you if you desire correction.

Is my right breast bottoming out? (Photos)

Answers (12)

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