Bottoming Out Breast Implants

Breast Implants Bottoming Out After Breast Augmentation

If you know a few things about the recovery process following breast augmentation, you probably have heard about ‘bottoming out’. Many patients are familiar with the term but have no idea what it implies. Following a breast augmentation, the implants initially ‘ride high’ on your chest and do take time before settling down into the right position within the breast pocket. Bottoming out happens if there’s no adequate support during this process, which causes your implants to drop too far down.

A bottomed-out implant will appear to be sitting below your natural breast fold. It looks like the implants dropped below your real breast. If you look from the front, your nipple appears to be too high on your breast. If looked from the side, the nipple appears to be pointing skyward due to the increased distance between it and the breast fold.

What causes bottoming out?

Bottoming out generally happens if:

  • The surgeon lowered your natural breast fold – during the augmentation, your plastic surgeon may disrupt the inframammary fold that’s attached to the rib cage (causing no support for your implant).
  • The implant pocket is over dissected – if the pocket that contains your implant is cut too large, then the implant may push downwards from the inside.
  • Your implants are too large for you – in the case your implants are too heavy for your body, they may push down under the breast fold.
  • Weak Tissue – sometimes from breast feeding, smoking, losing a large amount of weight associated with diet or pregnancy,

What can be done to correct bottoming out?

If your breast implants have crossed the line south of the border, what can be done to correct this situation? Revision surgery is the best option to correct post-op problems after augmentation. Depending on the extent of the ‘drop’, your cosmetic surgeon may decide to sew the capsule under the breast in order to push the implant up higher. Sutures or a flap of tissue will be used to accomplish this. The downside is that the stitches can lead to scarring.

An alternative approach involves using tissue substitutes such as Strattice or Alloderm to hold the breast up and provide adequate support for the implant. Depending on the nature of bottoming out, your surgeon may also choose to pursue a mastopexy (a breast lift).

What can I do to prevent this?

If you’re in the planning stage of your augmentation, then you may have a chance to prevent bottoming out.

The best course of action you can take to prevent revision surgery is to choose your cosmetic surgeon very carefully. Do your homework (read reviews) and only work with a professional who inspires comfort and confidence in you. Specifically ask questions about what can be done to prevent bottoming out and other post-op problems.

Am I at risk?

If you’re concerned about being at risk of bottoming out, don’t try to diagnose yourself. Consult with Taylor Theunissen, MD Plastic Surgery about this and any other worries that you might have. Contact our Baton Rouge office today to find out more at 225-412-2165.