Bottoming out? Almost 1yr post op. (photos)

It's been almost a year since my augmentation surgery (submuscular). I had asymmetry before surgery but concerned that my right breast is bottoming out and left one seems to look like ptosis. Left breast started feeling looser with lateral discomfort when I lay on that side, right one has no pain but slight tingly sensation here and there once in a while on the crease. Should I talk to my surgeon about revision surgery?

Doctor Answers 4


you had asymmetry before the surgery. they are sisters not twins and they are both attractive. relax and leave them alone

Newark Plastic Surgeon
4.7 out of 5 stars 59 reviews

Bottoming out breast implant? Almost 1yr post op.

You have very large breast implants and your inframammary crease appears to be intact.  The difference that she see on the right side is likely due to the asymmetry that she had preop.  If you are troubled enough to have a revision surgery will be required to elevate the right inframammary crease and you will likely need a smaller implant.  Considering the size of implants that you have an preexistent asymmetry I think your result looks quite good.

Bottoming out after Breast Augmentation

Thanks for your question! Based upon your photos, I'd say that you largely have a great result one year out, and you need to carefully weigh the pros and cons of going back in for a revision. That being said, you might have a slight amount of bottoming out on your right. Not sure if it's worth the risk of additional surgery yet though. I do hundreds of breast augmentations and revisions per year, and I'm in you area in LBK if you need any help. Best of luck to ya!

Robert P. Schmid, MD
Lubbock Plastic Surgeon
4.9 out of 5 stars 28 reviews

Repair of bottoming out

Surgery is the only effective remedy. Revision surgery is almost always more complex than breast augmentation. Correction techniques vary based on your plastic surgeon’s experience and skill sets. Always choose a board certified plastic surgeon with expensive revision experience as even in the best of hands recurrence is frequent especially if larger implants are used. Repair techniques include some of the following techniques and recommendations:
  1. Textured implants (“Velcro effect”)
  2. Use of Smaller Implants
  3. Maximum Submuscular Position (not just the pectoralis major but abdominis rectus below and serratus anterior on the side)
  4. Capsulorrhaphy (tightening the pocket by sewing in-folded capsular tissue together)
  5. Use of Biologic fabrics and other materials such as Acellular Dermal Matrix, “ADM” Alloderm, Strattice, “Silk” and others that can be used to reinforce the bottom of the pocket.
  6. Change of position of implant to a new pocket location “neo pectoral pocket”
  7. Internal Ryan Procedure (sutures binding the inferior mammary fold to stronger underlying tissues (e.g. fascial, periosteal)
  8. Removal of Implants and replacement of volume using your own fat (Fat Transfer).
The procedure is performed under general anesthesia on an outpatient basis most often using an existing scar or making an incision beneath the breast. Recovery is similar to your original breast augmentation procedure. Use of taping after surgery and prolonged use of a support bra is often recommended. It is far more important to pick the best plastic surgeon rather than trying to pick the best procedure as they are in the best position to guide you to the right decision

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.