Bottoming out at only 3 weeks post op? (photos)

Question

I'm worried that my left implant is bottoming out. The areola sits much higher and the crease is slightly lower. I am about 5'2, 50kg, I do not remember my BWD but I have a 28inch chest. As you can see in my before picture I do naturally have a fuller lower pole so I'm not sure if my left implant is bottoming out or if my right implant is just taking longer to drop? At only 3 weeks post op I feel like it may drop significantly more over the next couple months and that is my real worry.

Martin Jugenburg, MD · Answer

From your
pictures, it seems look like your implants are bottoming out. 
Bottoming out is
common when the inframammary fold is released and not firmly sealed and
reinforced.
A weak
inframammary fold will result in downward breast implant displacement once the
breast implant slips below the natural or surgically lowered inframammary
crease overtime.
Clinical signs:
·        
Bottomed out implants end up too low on the chest
wall with the inframammary scars travelling up onto the breast skin.
·        
The nipples will not only point upward, but also
be positioned higher on the breast mounds.
·        
There will be no pain, but you may notice thinning
of the skin at the bottom of the breast, which will allow you to more easily
feel the breast implant.
It is good to be
wearing supportive bras as this prevent further bottoming out. Supportive bras
will apply upward pressure to the fold at the bottom of the breast. 
To correct “bottomed out” breasts, a surgeon would need to secure the
implant in an elevated position and then reinforce the implant capsule at the
bottom of the breast with a suture technique. There may be a need for Acellular
Dermal Matrix, a soft-tissue graft, in the repair. A smaller implant is often
advisable, if the original was too large. In fact, receiving an implant larger
than indicated by your breast characteristics and boundaries increases the risk
of malposition. Since you are only 3 weeks into recovery, you will have to wait a few months for a revision if deemed necessary.
Please continue to have regular follow-ups with your surgeon
to make sure your breasts are healing. Their recovery instructions should take
precedence over all else you read here as they are better informed about your
surgical details.
Hope this helps.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
The photos provided demonstrate that the left implant has dropped with loss of superior pole volume with the nipple areolar complex residing high on the "cone". 
I would discuss this issue with your plastic surgeon. Some may recommend vigorous upward massage to prevent the superior aspect of the pocket from shrinking down and the wearing of a support bra for an extended period of time. Results are variable. Allow the implants to settle in over 6 months or so and reassess. Perhaps a revisional procedure to secure the inframammary fold will be required. Too early to tell.
Best wishes!

Bottoming out at only 3 weeks post op? (photos)

Answers (2)

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