Can you strengthen your lower breast poles?

I have bottomed out and was wondering if I take out the implant can I strengthen my lower pole and wait a while and then put new implants in? If so, what's a good time line

Doctor Answers 3

Bottomed out

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I think you are mixing up different issues--typically the capsule can be sewn off to correct a bottomed out implant.  If the implant is under the muscle it helps hold it there.  However, the laxity of your native tissues will not change.

Good Luck!

Can you strengthen your lower breast poles?

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If I read you correctly I think that the answer is yes.  Having implants out will allow for some skin tightening perhaps allowing for placement of a smaller implant after six months.  On the other hand, I have found that capsulorrhaphy and exchange to smaller smooth implants (though textured would also be sensible) can be done successfully in one stage.  I use a 6-8 week routine after surgery to strengthen and support the new crease and have had very good results.  Consider this when you meet with an ABPS Bd Certified plastic surgeon.  Good luck.....

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Bottoming out after BBA

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Thanks for your question.  Unfortunately, their is no reliable way to "strengthen" your lower breast pole.  When an implant is placed, even in a sub pectoral position, the lower aspect of the implant is still subglandular.  Over time, that tissue can stretch, resulting in "bottoming out".  Additionally, if the inframammary fold was lowered, or released, this can further allow the implant to drop.  Certainly, removing the implant, and repairing the fold, followed by a period of healing and then implant replacement is possible.  I would wait at least 6 months for the tissue to heal and mature. In that scenario, using a smaller and perhaps a textured implant may decrease the risk of bottoming out.  That being said, the propensity to bottom out has much to do with the patients intrinsic breast tissue and how "stretchy" it is.  Some patients just have weaker collagen, either genetically, or due to age/ pregnancy.

In summary, although you can't change your basic tissue quality, there are things that can be done to improve your breasts.  I have used both ADMs as well as SERI silk mesh to add additional support beneath the implant in such cases.  This technique can significantly improve bottoming out.  I suggest that you seek a consultation with a surgeon who has considerable experience in revisionary breast augmentation. He/she should be able to offer you options that best fit your goals.  Best Regards

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