As one of the most popular cosmetic surgery options each year, breast augmentation is a procedure designed to increase the breast size and volume, delivering the body contours you desire. While your breast augmentation procedure delivered the results you were looking for, complications down the road can affect the way your breasts appear. While rare, breast implants bottoming out is one such complication. But what causes bottoming out and is there anything you can do to help prevent it?
What Is Bottoming Out?
Bottoming out is a condition where the breast implant falls below the inframammary fold, or the crease below the breast. This causes the implant to move downward and the bottom of the breast to increase in size. While this can happen to both breasts, it is more likely to only occur on one side, giving an asymmetrical appearance with the nipple appearing unusually high, often pointing upwards.
What Causes Bottomed-Out Implants?
While bottoming out is not a common condition, there are many different factors that can contribute to this condition. Those factors can include:
- Large implants – If an implant is too large for the pocket it is placed in, it can put pressure on the inframammary fold and bottom out.
- Thin or inadequate breast tissue – If the existing breast tissue is thin or weak, it may be unable to support the implants, causing them to shift position.
- Changes to the inframammary fold – In order to accommodate larger implants, oftentimes surgeons must lower the natural inframammary fold. If the surgeon fails to affix this lower fold to the chest wall, the weight of the implant can cause it to drop and bottom out.
- Implant placement – Implants placed over the muscle rely solely on the breast skin and tissue for support. Implants placed under the muscle have additional support that can help reduce the risk of bottoming out.
- Lack of breast support – Not wearing supportive undergarments during recovery, as well as vigorous exercise, can include the risk of breast implant movement.
How Do I Know if My Implant Has Bottomed Out?
While settling and dropping is normal during breast augmentation recovery and as they adapt to your body, bottoming out exceeds that normal drop. Other signs and symptoms that can indicate a bottoming out of your implants can include:
- Nipples that begin to point upward or seem to sit higher up on the breast
- An increased distance between the location of your nipple and breast crease
- A bulging appearance to the lower part of your breast
Can I Prevent Bottoming Out?
If you are concerned about your breast implants bottoming out, there are some things you can do both before your breast augmentation and after. When planning your breast augmentation, you want to consult with your surgeon about potential risk factors and what they advise based on your existing breast tissue and body frame. You may also want to consider a breast lift for additional support, submuscular implant placement, and an implant size that best matches your body frame.
After your breast augmentation, you want to be sure to wear a support bra during recovery and for at least a year after your procedure. You want to refrain from any activity that causes bouncing after your procedure.
Fixing Bottomed Out Implants
Treatment for bottomed-out breasts involves a breast revision procedure where the surgeon can choose a variety of different options. These options can include repositioning the existing implant and reinforcing the surrounding tissue, moving the implant placement to under the muscle, replacing the implants with smaller implants, or adding a breast lift to the revision in order to provide additional support to the implants.
When planning a breast augmentation, it is important to go over the procedure and potential complications and how your surgeon plans to address those issues. If your current breast implants are bottoming out, there are options that can help you restore a natural appearance and the curves you wanted with your initial procedure.
Dr. Joseph J. Castellano is a native Floridian who grew up in the Tampa Bay area. During medical school and his 5 years of training in General Surgery, Dr. Castellano developed a strong interest in Cosmetic Surgery. He followed his residency training with an elective year of specialized training with the American Academy of Cosmetic Surgery. From 2010-2011, he completed a fellowship in Indiana focused entirely of cosmetic surgery of the face and body. During his fellowship, he received specialized training in facial rejuvenation, breast augmentation, abdominoplasty, and body contouring. Dr. Castellano received his board certification from the American College of Surgeons in 2010.
Dr. Castellano focuses on breast augmentation, abdominoplasty, liposuction, facelift, and eyelid rejuvenation. Additionally, he operates on numerous skin cancers, scar revisions, spider veins, and specializes in the management of aging skin with chemical peels and laser resurfacing.
Request a consultation to meet with Dr. Castellano and learn more about all his practice has to offer.
