2 Months post-op, 325cc, Silicone Gel, Under Muscle: Am I bottoming out? (photo)

Question

I'm 9 weeks post-op. I got 325 cc silicone gel under the muscle. My incision scar is high, as well as my nipples. Am i bottoming out?

John Michael Thomassen, MD · Answer

Yes it appears you are.  In the very early period, taping or wearing a strap under the breasts can help correct this.  But more than likely, correction will involve a return to surgery to suture the breast capsule under the implants.  You should eventually have a great result.  Best wishes!

Asif Pirani, MD, FRCS(C) · Answer

It does look like you are starting to bottom out.  You should see your PS ASAP to begin preventative measures.  Best,

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your pictures. Your bottoming out. You have excess distance between your nipple and your fold. This produces a high incision that is visible and a high upwardly pointing nipple. I would recommend revision of this by using an internal bra method (STRATTICE)Earl Stephenson Jr MD DDS FACS

Jason E. Leedy, MD · Answer

A large implant in a relatively small breast that doesn't have strong tissues will tend to bottom out over time.   There are some manuevers that can be performed intraoperatively to avoid this complication.  One of the most important things is to avoid overdissection of the breast fold.  This alone will help avoid the complication.  So prevention is the best thing, but if bottoming out becomes apparent early on I would recommend wearing a supportive bra 24/7.  It takes a few months for the body to form scar tissue that will hold an implant on the chest wall and while that process is going on wearing a supportive bra may help prevent downward migration of the implant.  In my patients that I'm concerned may drop farther than I want (because they wanted a larger size for their breast), I have them wear a supportive bra 24/7 if the implants have settled before the 3 month period.  I hope this helps.  Best of luck.

Ryan Neinstein, MD, FRCSC · Answer

I would suggest wearing an underwire bra and hopefully catching the end of the inflammatory period to scar down the bottom of your breasts

Angela Champion, MD · Answer

Yes, it does appear from the photo that you are bottoming out.  You will most likely need surgery to correct this so talk with your surgeon for details about the procedure to tack up the fold.  That should hide your incisions and your nipples will be at a more central location on your breast mound. Your recovery should be relatively easy but make sure you wear a supportive bra and follow post-op instructions closely.  Best of luck! ac

Darryl J. Blinski, MD · Answer

Appears so but only in person opinions apply. Seek a few from boarded PSs in Toronto. Good Luck.. ///

Jourdan Gottlieb, MD · Answer

Thanks for your question and photo.This does indeed look like bottoming out. The implants seem to have descended below the original breast crease and are set too low on your chest.  Consequently the nipples appear to be too high (which they are not) and too much volume is below the nipple, too little above. At some time, after 6 months or so after surgery, you would be well served by a secondary procedure to close off the lower pocket and reinforce the breast fold.All the best.

Teanoosh Zadeh, MD, FRCSC · Answer

Hi, I tend to agree
with the comments below, that your implants are bottoming out and give the
false appearance that your nipples are higher, when in fact you have more
breast skin showing below your nipple areolas then above. There is a remedy for
this, however I would wait six months before contemplating a procedure. Your
surgeon would simply open the incision and close off the pocket below your new
fold and therefore allow the implant to rise. Best of luck to you.

Benjamin Chu, MD, FACS · Answer

You are starting to bottom out.  This is usually due to minimal internal scar tissue and lack of breast support early after breast augmentation.  All implants will tend to drop over time especially if you don't wear good support.  Once the implants have dropped to the ideal position, I recommend the use of a cupped bra with some padding on the lower part only.  This helps to push the breast implants up.  With constant use of the bra day and night the internal pockets will shorten.  Once the internal scar has matured the internal scars will stretch less.  Some times you can use a cupped bra without padded and insert a small gel insert (chicken cutlet) on the bottom of the bra to elevate the lower pole of the breast and I have seen the implant position rise after a few months.  You can not go without a bra during this time.

2 Months post-op, 325cc, Silicone Gel, Under Muscle: Am I bottoming out? (photo)

Answers (13)

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