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Breast Implants Bottoming Out

Bottoming out can be very, very difficult to fix, either internal capsulorrhaphy, plicating the capsule and pulling the implant up and/or with an inframammary formal breast lift may be required to regain a normal shape, bringing the nipple back into the center of the breast and the implant upward superiorly to a normal shape and a normal position.

This is very difficult to correct and one of the most difficult surgeries. Capsules are often very, very thin and often will not tighten appropriately. Bottoming out is usually associated with simply giving out of the pocket along the inframammary fold.

This could be due to several reasons. One is simply technical error. The plastic surgeon may simply lower the fold too much and the implant has now fallen by gravitational descent to a very low position and now the nipple appears to be in an overly high position.

It can also be associated with simply very large implants placed, especially above the muscle with inadequate postoperative support. In other words, women who do not wear their supportive brassieres or regular brassieres during the day and athletic brassieres at night, thereby gravity of the large implants is pulling the implants down inferiorly and causing the bottoming out as time goes on.

Bottoming out is a very difficult problem to reconstruct. Once again, it often requires a breast lift in our practice, removing skin along the inframammary fold and thereby a scar, which can often be hidden in the inframammary fold. Trying to tighten the capsule internally often does not work and it simply tears out with time and you will get recurring bottoming out.

It is essential that you see a Board Certified Plastic Surgeon before having your original surgery so that he or she has the technical ability to not lower the inframammary fold too much and thereby bottoming out is reduced over time.

 

• Capsular Contracture
• Double-Bubble Deformity Or High Riding Implants
• Anatomical Implants
• Bottoming Out
• Ruptured Implants
• Desire for Different Size Implants (Change in Volume)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stuart A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.

Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery.

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Board Certified Plastic Surgeon
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