Bottomed out Right Breast Implant?

I feel like my right breast implant has bottomed out. I am 2 weeks post op. It has been this was since day one. I was a 34B and went to a 34C with a 325cc mod plus saline implants filled to 350 in the L and 360 on the R. I can feel the bottom of the saline implant and at an angle, you can see where my breast tissue ends and the implants extends below it. Did my doctor make the pocket to low? Has my implant bottomed out? Thank you!

Doctor Answers 4

Bottoming out of Breast Implant?

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Thank you for the question. Without pictures or examination it is not possible to give you specific advice.

One of the most common complications after breast augmentation surgery is implant mal-position. This occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (“riding high”), inferiorly (“bottoming out”), medially (“symmastia or uni-boob”) or laterally (falling outward into the axilla).

Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.

I hope this helps.

Need pre-op photos to be sure

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I would need to see your pre-op images to be sure but it doesn't look like bottoming out to me. Your tissues have not relaxed yet. It is early. What is your surgeon telling you?

John P. Di Saia, MD
Orange Plastic Surgeon

Bottoming out sometimes associated with constricted breast

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It is difficult to tell without reviewing your preoerative pictures. I have observed this condition in individuals who present with a constricted breast.

In these instances, the pocket was not made too low but the lower half of the breast was inadequate to completely cover the lower half of the implant producing visibility and palpability of the implant.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast Implant Bottoming Out

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Bottoming out occurs when the implant descends below the inframammary fold (the crease at the bottom of the breast where the skin attaches to the chest). In most cases of breast augmentation the inframammary fold is not disrupted during the creation of the implant pocket and represents a 'shelf' upon which the implant will rest. In some cases it is necessary to disrupt the inframammary fold and create a new inframmamry fold positioned lower than the original to allow the implant to settle in this lower position. This is often done to provide the augmented breast with an ideal shape and positioning.

When the inframmamry fold is disrupted and a new one created, there is a higher risk of bottoming out because early on the new fold is not firmly attached and the weight of the implant can cause stretching of the lower breast skin and descent of the implant below the new 'shelf.' Even when the inframammary fold is not disrupted, the weight of the implant and the stretching of the skin (particularly in women with thin skin) can still disrupt the existing inframammary fold and cause the implant to settle below the fold.

Whatever the cause, be rest assured that if this does occur, it can be readily correctable.

Louis DeLuca, MD
Palm Beach Plastic Surgeon
4.9 out of 5 stars 58 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.