Bottom out or just sagging? Do I need additional surgery? (Photo)

Question

I got mybreast lift with implants just over a a year ago. I was extremely happy with the results up until 6-8mo post op. Now I feel like I have no upper fullness and my breasts just look saggy in my opinion. I have to constantly wear a push up bra which I didn’t think would be needed. I will post pre-op and post op pictures below! Am I bottoming out? Do I need an additional surgery? How do I get upper fullness or is that just not so-able with my body type?

Ronald J. Edelson, MD · Answer

I think you actually have a pretty good result. I’d be interested in knowing whether you had a lolllipop type lift or an anchor lift. If you had the lollipop it could be converted to an anchor to tighten the lower portion of the breast. But the extra scar might not be worth it

Ajaya Kashyap, MD · Answer

Thank-you for your question. Based on your history and photographs what you have is “bottoming out”. It seems you had a vertical scar only mastopexy with breast augmentation . The appropriate procedure for you now would be to convert this to an anchor shaped breast lift and reshaping of the breast tissues. Please discuss all your concerns with your Plastic Surgeon who can examine you and help you with your issues. All the best!

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear tme122,
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

Connie Hiers, MD, FACS · Answer

Your implants are probably too large and heavy on your tissue and have bottomed out. The inferior pockets could be tightened to relift. However, you would do better going with something smaller and less heavy so this will not occur again.

Jason Pozner, MD · Answer

Looks like just tissue stretch. Need to see folds with breasts lifted or in person to see if bottomed out. Treatment is same - I would revise the lift with Galaflex mesh for support. We have women in their 70's now with high,  perky breasts that dont require a bra since we have been using Galaflex

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