Bottoming out is a rare deformity in which the breast implant migrates under the inframammary fold. Corrective surgery can create long-lasting results that meet and exceed the expectations of your original augmentation.
What Is Bottoming Out?
During a breast augmentation with implants, the surgeon creates a pocket above or beneath the chest muscle to hold the implants in place. In a minimal number of cases (about one or two percent), the implants can migrate underneath the inframammary crease. This movement may create an irregular shape, breasts that hang at different positions, or breasts that are very low while the nipples remain in their original position.
Implants too large for a woman’s body proportions are the most common reason for bottoming out. Large, heavy implants can migrate downward if the breast tissue cannot support them. There is a much lower risk of bottoming out when the implants are proportionate to the rest of a woman’s body.
Bottoming out correction will differ significantly depending on the cause of the complication and the individual patient's goals. During your initial consultation, your surgeon will listen to your implant history and perform an extensive exam to help determine the correct type of procedure that will be the safest and most effective for you.
Importantly, when you choose to remove and replace implants, your surgeon will help you select the incision technique and implant type, size, and shape that will achieve your aesthetic goals and help to avoid a similar problem. Your surgeon will also help you create a detailed pre-operative plan for optimal results.
Bottoming out corrections vary depending on the cause and the patient’s needs. During the procedure, incisions will be placed as discussed during your consultation. The same incisions from the original surgery will be used to minimize scarring whenever possible.
Some procedure options include:
Removing current implants and replacing them with a more appropriate size or profile
Replacing implants underneath the muscle
Lifting the breast to a higher position on the chest wall
Restructuring the breast pocket to hold the implant more securely
Reconstructing the breast crease to resist the downward movement of the implant
To close the incisions, your surgeon will use a unique layered suturing technique that minimizes tension to minimize scarring.
It is normal to experience some soreness and swelling for the first two weeks following your bottoming out correction. Pain relievers and cold compresses are typically used to ease these side effects during the early portion of the recovery process. Some revisions require extensive pocket repair that requires wearing a specialized bra.
Your surgeon will provide specific instructions for optimal post-operative care, including an advanced scar management protocol after the initial healing period. Your surgical team is always available and will closely monitor your recovery in the weeks and months following surgery.