18 months post op - bottoming out / implants too big? (Photos)

Question

I had a breast lift and implants 18 months ago, and I feel like they have dropped massively and are sagging. They feel very bottom heavy and one is sitting a lot lower than the other. I am going to see my surgeon but I am a bit nervous as im not sure if this is just the normal result of a breast lift. I have looked online and not sure if this would be bottoming out, or if perhaps the implant is just too big for my frame!

Tyler Frew, MD · Answer

Hi there,
Seeing your surgeon is exactly the right next step. Some settling after a lift with implants is normal, but one side sitting noticeably lower and a bottom-heavy feel at 18 months is worth a proper exam. Your surgeon can measure where each implant sits compared with your fold and tell you whether this is normal settling, the implant dropping, or a size and tissue issue. Each of those has a different fix.
Write down your questions beforehand and bring photos from your early recovery for comparison. An in-person exam is needed for personal advice.
All the best!

Gary M. Horndeski, MD · Answer

It is possible for implants to bottom out and this has occurred in your case. You will need repair of the bottomed out pockets by sutures or possible use of a mesh. Smaller implants would lighter and less of a load on the breast.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Yasemin Aydinli, MD · Answer

Your photos show stretched lower poles with the implants sitting low and the nipples pointing upward, more on one side. This is not the normal settling after a lift; it looks like bottoming out, where the implant has stretched the tissue below it and moved down. It can happen even in careful hands, especially with heavier implants and thin tissue. The repair usually involves tightening the lower part of the pocket with internal sutures, supporting it with a mesh such as GalaFLEX, and often choosing a smaller or lighter implant. Tightening the skin of the lower breast again is commonly needed for a good shape. Discuss these options with your surgeon at your visit.

18 months post op - bottoming out / implants too big? (Photos)

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