I have no cleavage and nipples hanging out of bras and bathing suits. Is my implants bottoming out? What to do next? (photo)

Question

I had a BA on April 29th 2015 - 420cc Natrelle Inspira SSX under.I noticed right after the surgery that one breast seemed lower+ had a sag to it and just got worse and worse. July 10th I had a surgery to move my nipple down (they were uneven before surgery) + the breast still looks lower. The incision is way higher than the other.I found that both my nipples were constantly hanging out of bras. Seems to be a lot of fullness in the lower half and not the upper, making my nipples high

Richard J. Restifo, MD · Answer

Based upon your pictures and the story you tell about the nipples peeking out seems like a case of "bottoming", i.e. the implants are somewhat too low relative to the nipples.  Fortunately, this can be corrected by suturing the pocket capsule at the lower crease, but this will require more surgery.   It can be fixed "from the inside" through the incision that you already have. There is no rush to correct this situation and it may make sense to wait a few months until the settling has completed and the tissues have healed and firmed up. You should discuss these options with your plastic surgeon.  Best wishes.

Jonathan Saunders, MD · Answer

I wish I could see your preop pictures. I am wondering if you had the same preoperative asymmetry.? did one breast com eoff the chest wall higher than the other one did?

Jeffrey A. Sweat, MD · Answer

Believe it or not, studies have actually been done to determine the aesthetically "perfect' breast and by the standards judged by experts for a natural and aesthetic breast, there should be more fullness in the lower part of the breast than the upper part and the nipple should point very mildly upward.  In that regard, you have very aesthetically pleasing breasts right now.  However, most women who undergo augmentation want more upper pole fullness rather than lower pole, which is what you are lacking.  Additionally, augmentation patients generally want cleavage as well.  Cleavage cannot be produced by an augmentation due to the varying width of the breast bone and size of implants and should really be achieved with a supportive bra.  As far as upper pole fullness, this is a very unnatural, yet sought after, breast shape.  I would say that your surgeon has done a great job, but if you want more superior fullness and less problems with nipples showing through the bra, then raising the implants would be the solution, though can be at times unsuccessful.  Best of luck and I truly hope you achieve the results you seek!  Have an honest conversation what your plastic surgeon about what you are looking for and hopefully you can both agree to a solution.

Tom J. Pousti, MD · Answer

I am sorry to hear about/see the problems you are having after breast augmentation surgery. I think your concerns are understandable; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”). Also,  consistent with the breast implant positioning problem, the nipple areola complexes seem to be sitting relatively high, because the breast implants have settled too low. 
I think you will likely benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair).  This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly.  Associated issues with positioning of nipple/areola complexes   should improve with this operation.
Make sure that the plastic surgeon who does this procedure for you can demonstrate significant experience with revisionary breast surgery. 
I hope this, and the attached link, helps. Best wishes.

Jed H. Horowitz, MD, FACS · Answer

You are still pretty early postoperative and it is difficult to comment on the results without seeing preoperative pictures. I would give yourself a little more time to heal and continue to follow-up with your plastic surgeon. Sometimes if you have a lot of preoperative asymmetry this is not corrected with an implant. You do have some bottoming out of your implant on your last pictures. However, I would recommend waiting a few more months before you consider revision surgery. #BreastAugmentation #PlasticSurgery #Recovery #Healing

I have no cleavage and nipples hanging out of bras and bathing suits. Is my implants bottoming out? What to do next? (photo)

Answers (9)

Answer: I have no cleavage and nipples hanging out of bras and bathing suits. Is my implants bottoming out? What to do next?

Answer: I have no cleavage and nipples hanging out of bras and bathing suits. Is my implants bottoming out? What to do next?

Answer: Breast Augmentation - Postop Results

Answer: Breast Augmentation - Postop Results

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Everything you need to know about Breast Augmentation

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I have no cleavage and nipples hanging out of bras and bathing suits. Is my implants bottoming out? What to do next? (photo)

Answers (9)

Answer: I have no cleavage and nipples hanging out of bras and bathing suits. Is my implants bottoming out? What to do next?

Answer: I have no cleavage and nipples hanging out of bras and bathing suits. Is my implants bottoming out? What to do next?

Answer: Breast Augmentation - Postop Results

Answer: Breast Augmentation - Postop Results

Browse related questions

Recommended reading

Everything you need to know about Breast Augmentation

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