I am a little over 1 year post op. I feel as if my breasts have dropped. Do they look like they have bottomed out? (Photo)

I had a mommy makeover a little over a year ago. I had a breast lift & high profile silicone implants. 550cc in left and 500 in right. I've always felt like I don't have the cleavage I'd hoped for but I still loved the result. But here lately I feel as if they look like they've dropped more. I wore a 38D before and now I'm a 36 DDD. I had lost quite a bit of weight prior to surgery and 25 pounds since the surgery. Do I look like I have bottomed out?

Doctor Answers 12

Bottoming out

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Over time the skin stretches, and yours may have been exacerbated by weight loss and heavier implants.  You can consider a revision to tighten up the lower pole of the breast.  If you are unhappy with the size, an implant exchange could be done at the same time.

Houston Plastic Surgeon
4.9 out of 5 stars 36 reviews

Post-Op Breast Lift and Augmentation Healing

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Over time, gravity will continue to have an effect and the breast skin will tend to stretch. The degree of #stretching and #sagging varies between women: generally, women with smaller breasts experience less recurring sagging. If sagging does occur, further excision of the skin on an outpatient basis can be used to correct the problem. Heavy and large breasts may lead to recurrent sagging and may require the removal of a small amount of breast tissue to achieve an optimal shape and size. One key to a satisfying result is realistic expectations.

All surgical procedures carry some degree of risk. Any breast operation can result in changes in sensation. This happens less with lifts than reductions but is still possible. Occasionally, minor complications occur and do not affect the surgical outcome. Major complications associated with this procedure are rare. The suitability of the breast lift procedure and specific risks may be determined during your consultation. You may be able to carry on massage of the surgical area of the breasts to help with comfortable placement of the implants, but textured implants do not require breast massage. You should be informed about this by your doctor at your post-operative visit, but if you were never told anything about this it may be a good idea to have another live appointment with your surgeon to make sure that everything is healing well.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Revision after mommy makeover

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Thank you for your question.  Since you had weight loss after your surgery, you have more loose breast skin.  In this situation, I would consider exchange to smaller implants, pocket revision and a breast lift to tighten the skin.  Be sure to consult with an experienced board certified surgeon.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

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Revision Breast Surgery

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When having lift with implants at the same time-- I personally do not recommend that my patients go larger than 325cc. In order to achieve the best lift- patients have to compromise on a size of implants . Unless a patient does a lift first, wait until it heals then a patient can choose larger implants. So, in your case I would recommend take the implants out, and redo a lift, wait 90 days, and then you may re-augment with larger implants that you like

Bottoming out of the breasts one year after mommy makeover surgery.

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The distance from the areola to the infra mammary fold is definitely too long. This is called bottoming out. Revision of the breasts can solve this aesthetic problem. If the implants are in a sub muscular position consider moving into a sub glandular position.

Bottoming out vs recurrent stretch?

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Thanks for your pics and question.  #Breast lifts maintain blood & nerve supply to the nipple-areolar complex, while reducing excess skin and migrating the NAC higher on the chest wall, however the surgical technique doesn't strengthen the breast skin, especially when a large volume implant is added, like in your case. The smooth surface of the high profile implants coupled with the submuscular position creates a "plunger effect", which pushes the implant "down and out" off the original position on the chest wall, thereby widening your cleavage.  #Bottoming out represents increased nipple to fold distance.  #Recurrent stretch involves displacement of the entire bra and implant so the breast slides inferolaterally.  Check with your PS for options, which may include 1. internal bra support; 2. downsizing implant volume; 3. revision mastopexy; 4. conversion to textured anatomical device.  

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Breast implants and lift - have I bottomed out?

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Thank you for asking about your breast lift and implants.
  • You haven't bottomed out but with the weight of the implants, your breast tissue has stretched and the implants are sitting lower.
  • With weight loss after surgery, you probably lost fat in the breasts, leaving the breast skin looser.
  • To try to restore your original look, you would need smaller implants to put less stress on your tissues plus, revision of the pocket and some internal support material such as ADM or vicryl mesh to support the implants.
  • If you want to keep the implant size as is, you can still have surgery but the sagging is more likely to return 
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Skin stretch

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It appears you had a good result, then over time with continued weight loss(and with the large implants)your skin in the lower pole has stretched(this will always happen, just a matter of how long it takes). You should consult with your surgeon and see what he/she is willing to do for you at this point.

I am a little over a year PostOp. I feel as if my implants have dropped, do they look like they have bottomed out

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Thank you for sharing your question and photographs.  Though there is no clear evidence of your implants bottoming out, it does appear that due to your skin quality, weight loss, and implant size that your breast tissue has stretched.  I would recommend seeing your surgeon and discussing your current results. They can offer you the best treatment option. 

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

I am a little over 1 year post op. I feel as if my breasts have dropped. Do they look like they have bottomed out?

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It does appear that you have stretched out, especially along the inferior pole of both breasts. Best to see your operating surgeon to see if he or she can remove the excess skin  to improve your breast shape. Good luck!

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.