Slight Bottoming out. Should I Get A Revision?

Question

I was just confirmed to have slight bottoming out on my right breast. I have 275cc cohesive unders. My question is will it continue to get worse? I am 4 months post op. with my arms down, they look good just a little asymmetrical. With arms raised it is noticeable. Hasn't really changed since 6 weeks. Sould I get revision? It just bothers me as I can feel that I have an implant in right breast and my left feels 100% natural. Anything I can do to stabilize it or am I too far post op?

S. Larry Schlesinger, MD, FACS · Answer

From your description, your right breast implant is sitting slightly lower than it should.  For argument sake, let us assume that your pocket is open enough on the right at the top to allow the implant to move up even if the implant was sitting at the correct position.  If this is true, then I have a trick that might work.  Reston Foam (a 3M product) can be put on by your plastic surgeon with you lying down so that the implant is positioned higher.  Then immediate placement of an underwire bra and wearing the bra and the foam day and night for a couple of weeks can cause some obliteration of the lowermost portion of your implant pocket.

	 

	Take the foam off after 2 weeks and just wear an underwire bra for a couple of days to allow your skin to breathe.  Then have your surgeon replace the foam for 2 more weeks beneath the underwire bra.  This trick has worked in the past and it obviates, at times, the necessity for a second surgery and more scarring.

Jed H. Horowitz, MD, FACS · Answer

"Bottoming Out" is the term given to implant #displacement, where the implant drops down below the existing inframammary fold; the natural crease beneath your breast. This may occur when the fold has been released excessively during surgery or may be due to factors of the patient’s collagen and tissue integrity. The implants then sit very low on the chest with a lack of internal support for the implant itself.Correction usually involves #restoring the crease beneath your breast to it's normal position with internal reconstruction of the capsule around the implant (#capsulorrhaphy). Sometimes a biologic fabric (Acellular Dermal Matrix or #ADM) can be used to attach to the breast tissue internally while supporting the implant.This corrects the placement of the implant, redefines the breast shape, and also refines the internal fold.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Given that you are only 4 months out of your surgery, I would suggest that you not making decisions about revisionary breast surgery at this point. Generally, I think it is best to make this type of decision after waiting as close to one year after surgery as possible. Waiting this period of time  is smart;  it will allow both breasts  to reach their “final state”. At that time good decisions can be made regarding  the best option to improve breast symmetry.

	The use of a relatively tight fitting bra to support/ stabilize the breast implant that has “settled” too far may or may not be helpful  at this point.   

	I hope this helps.

Slight Bottoming out. Should I Get A Revision?

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Slight Bottoming out. Should I Get A Revision?

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Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.