325cc to 485cc - what can be done to repair if I am bottoming out? (Photos)

The size you chose is probably too large and heavy on your tissue and is sagging. Ideally, you would go smaller and support your tissue with an internal bra of mesh. If you want to try and keep this size, you will need mesh.

It's difficult to tell if you are bottoming out. An in person evaluation is best to help determine if this is occurring. With bottoming out the distance between the nipple and breast fold increases, shifting the nipple more upward. To correct this your surgeon may use mesh to support the tissues. I encourage you to speak to your surgeon about your concerns.

Bottoming out occurs because the weight of the implant stretches the skin and the skin in unable to hold the load. Going up to 485 cc implants, you are increasing the load and the situation will be even worse. You need to reconsider the size or consider fat transfer as an alternative.

Best Wishes,

Gary Horndeski, M.D.