Have my implants 'bottomed out' and what is the best fix? (photos)

I was happy with my augmentation until about 3 months ago. Now the lateral separation is getting bigger. The right breast is falling quite a bit more than the left. I was a large c cup, went to a large dd cup. I don't like the large size. Would like to go down to a large d and am open to a donut lift. Will that fix the problem?

Doctor Answers 9

Bottoming out?

Your pictures do not show bottoming out, which is the implant being located lower that the breast itself.  Rather, you have breast ptosis which makes the breast lower than the implant.  This is corrected by a mastopexy.  Donut mastopexy might be possible, but an overall better shape would probably be provided with a more classical 3 incision mastopexy, especially if you are going to downsize.


Indianapolis Plastic Surgeon
4.9 out of 5 stars 16 reviews

Have my breast implants 'bottomed out' and what is the best fix?

I do not see evidence of your breast implants bottoming out.  However there is significant lateral displacement of the right breast.

A combination breast lift, smaller implants, and a revision of the right breast implant pocket may be your best option. For more information please see the link below:

Breast revision options

Thanks for your inquiry and pictures, but without more details on the procedure, implant size, position, and your new implant goals--it is hard to advise.  A smaller implant can definitely decrease your bra size, but a dout lift will only minimally change to position of the breast.  Please have a couple of in person consultations to discuss your options.  

No bottoming out

Thank you for your pictures. You do not have bottoming out. You have large implants and droopy breasts due to Wright of the implants and your natural breasts. I agree with downsizing your implants but will most likely need an inverted "T" incision for your breast lift. 

Visit your PS

Thank you for the question and photos. You may be able to benefit from breast reduction and a breast lift if you want to reduce the size.  A donut lift is a possible solution but it is hard to say without an in person examination.  It is always best to visit a board-certified plastic surgeon and have a full evaluation for your concern. Best of luck. Dr. Michael Omidi.


An in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 63 reviews

Size change and lift

Thank you for the question and a size reduction and a lift could be performed at the same time but an examination and a discussion of desired results is needed.  So see some experts in your area.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

Breast augmentation - did I bottom out?

Thank you for asking about your breast augmentation.
  • If you are bottoming out, it doesn't show up well in the photos.
  • I suspect actually the implants are too big for your frame and the weight is pulling them down and out.
  • Your idea of a  smaller implant seems a very good one.
  • You need an exam to know if a donut lift or other lift is needed -
  • Certainly the pocket will need to be revised for a smaller implant.
  • If you like your original surgeon - consider returning to her/him as you will be charged less.
  • If you aren't happy because the size was her/his idea and wrong for you - find a new plastic surgeon and take your time to find one you feel is exactly right for you. 
  • Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Going smaller

 From the photographs you have submitted, it's my opinion that putting a much smaller implant will necessitate both some capsule work on the inside and a vertical left of the breast gland. In your situation, with the amount of breast tissue that you have below the areola, a doughnut type mastopexy will flatten the breast and not move that breast tissue below the areola upward at all. I recommend you see a board-certified plastic surgeon in your region for consultation. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 46 reviews

Breast lift with implant exchange?

Schedule an appointment with your surgeon so that the two of you can discuss your options. I'm not sure that a donut lift will be enough but you will have to weigh the pros and cons. 
My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 52 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.