14 years post op - Am I bottoming Out? (Photos)

Yes you have bottoming out which is typical for saline implants that have been in for many years. Because the tissue envelope is thin, you would likely benefit from adding and internal bra rather than simple capsulorrhaphy. Galaflex is an excellent choice for that, along with Motiva implants.

Hi, thank you for your photo.
The patterns you see is typical of bottoming out, and the rippling is common with older saline implants.Fixing this usually requires pocket repair to lift and support the implant back into the correct position.
In this situation, pocket repair is the correct approach. Simply switching implants without rebuilding the pocket would not lift the implant or restore the upper-breast shape you’re aiming for. A more cohesive silicone implant will also help to improve fullness and reduce rippling.
Best regards,Andaç Aykan, MD, Assoc. Prof.

Hi there,
Yes, after 14years you are bottoming out and moving more lateral. This is making your cleavage wider and loosing your upper pole fullness.
I’d recommend, remove and replace with internal pocket repair, especially laterally and inferiorly. When the pocket get closed down it will situate the implant more centrally on your chest which will improve both your cleavage and upper pole.
All the best

Over time, implants can settle low, thin tissue can expose rippling.

When ready to replace, revision can lift the implants higher for more upper fullness. Usually larger gels are recommended.

An exam and consultation with a plastic surgeon is recommended to further discuss your best options and expectations.

Thank you for your question. You definitely have what I termed "slide down " which is inferior descent of the whole breast and implant. Many times this is associated with implants on top of the muscle. In your case, I would perform an internal bra/capsulorrhaphy and a lift. I have been in practice for over 30 years and revisionary breast surgery is a large portion of my practice. You should be able to have an excellent result. Best wishes to you.

your implants do appear to be sitting low on the chest and quite far lateral. A physical exam would be needed to assess the exact cause of this and the appropriate surgical plan to correct it. Based on the photo you provided, revision surgery would likely include repositioning the implants in a higher position as well as strengthening the capsule laterally to help improve medial cleavage. How this is done- implant pocket (above/below the muscle), capsule repair, and possible need for internal mesh bra would be decided based on an examination. I would recommend finding a well trained plastic surgeon with a focus in revision breast surgery who can provide a surgical plan that is tailored to your goals and anatomy.
Sean Fisher, MD Aesthetic Plastic SurgeonSeattle, WA