Are they bottoming out? (Photo)

Hello! I had my BA 4 years ago. I wasn't happy about the size, but my PS said that he couldn't fit anything bigger. Now after looking at my breasts and paying more attention (as I was considering in having another operation to get 400cc, I have 325cc) to them, I think that they have bottomed out. I really hope that someone can help me and give me some advises. Thanks a lot!

Doctor Answers 5

Bottoming out

Thank you for posting your question and photos to Realself.

I agree with the other surgeons that it looks as if your implants have become slightly lower with time.  This it what causes bottoming out.

It is possible to correct this with internal repair of the pocket and I agree with the other surgeons that this is very specialist and it is important that the Surgeon you choose has specific experience with this.

Good luck

London Plastic Surgeon
4.9 out of 5 stars 148 reviews

Are they bottoming out? Perth, Australia

Thank you for your question and images. Your breasts do appear to have bottomed out. I can understand your disappointment in regards to your implant choice but I think there are some important lessons to take from your experience.

Your implants appear to have descended evenly and symmetrically. If this occurred after your original surgery then it would suggest that over time your implants have dropped through weakness in the inframammary fold. That is your bodies tissues have not been strong enough to support the weight of the implant and they have given way. 325cc implants are generally considered moderate to large implants. Anything from 350 and up would be considered large implants and therefore carry significantly higher risks of bottoming out over time.

Ideally, over your life time you should aim to minimise the number of surgical procedures you have on your breasts. Each revision surgery carries higher risks of complications and adds additional scar tissue to your breasts. Therefore if you are considering a revision procedure you should consider reducing the size of the implant to minimise future risk of further bottoming. I know that may be difficult to consider but the larger the implant the heavier they are and more likely they will cause problems in the future. 

Dr Guy Watts 

Are they bottoming out?

I am sorry to hear about/see the problem you are having after breast augmentation surgery. I think your concerns are appropriate; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”).
It is probable that you are feeling the implants significantly along the lower poles of the breasts. Patients in your situation often complain of discomfort in the area of implant malposition. 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 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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Are my breast implants bottoming out?

I am sorry to hear of your dissapointment. You do appear to have bottomed out. A pocket revision can be done to correct this. Please resad the linki below;

Bottoming out

Dear Maria,

thank you very much for sharing your pictures with our forum.

Yes there is a bottoming out and there is also asymmetry in the position of the inframammary fold - the left hand side being lower than the right.

The solution is a revision surgery to reduce the length of the nipple-to-fold distance and replace the implants in a better pocket (higher). You will also need to raise the left inframammary fold.

After a careful clinical assessment, many aspects will define what is the next step: changing size or shape of the implants, changing the pocket above or below the muscle: you will need to discuss with a board certified plastic surgeon your expectations and he will quantify what your body is ready to achieve.

I find that you have an excellent frame and I am sure you can achieve an excellent result from your revision surgery.

i wish you the best of luck,

Stefano Cotrufo, MD, PhD
London Plastic Surgeon
5.0 out of 5 stars 21 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.