Should I get a smaller implant when I get revision for bottoming out? (Photos)

Question

Hi everyone, my 535cc high profile silicone implants have bottomed out and went out to the sides. Photos are attached. I am planning on getting revision surgery with internal sutures. I wanted opinions of surgeons about the need for going smaller this time around and if I did go smaller, how much smaller of an implant would make a difference? I really do not want to go through another surgery and risk recurrence of bottoming out. Thank you!

Anna Steve, MD · Answer

Smaller implants are lighter, so they do have less risk of bottoming out. However, there are also many factors that contribute to bottoming out. Incorporating an internal bra product would be an excellent option for reinforcing the repair and supporting the new implants in position.

Daniel Barrett, MD · Answer

Dear Sunsandandsalt808,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Yes, you need to go smaller since your tissue will not support such heavy implants. I would suggest going down to least 400 to 450 max with possible mesh for added support.

Should I get a smaller implant when I get revision for bottoming out? (Photos)

Answers (3)

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