Bottoming Out

Bottoming out is a surgical complication that may occur after breast augmentation. If your breast implants are bottoming out, Dr. Boyd can perform breast revision surgery to correct this complication and improve your results.

What Is Bottoming Out?

Bottoming out is when a breast implant slides below the inframammary fold (the crease underneath the breast). When this occurs, the nipple-areolar complex will point upward and the upper pole of the affected breast will collapse. Bottoming out can affect one or both breasts and may make your breasts appear to sit on your upper abdomen instead of on your chest! It may also be associated with double bubble deformity.

Who Is At Risk?

Bottoming out only happens to approximately one to two percent of breast augmentation patients. The inframammary fold is produced by fibers passing from the skin to the underlying muscle and generally serves as a barrier to downward displacement of the breast implant. Nonetheless, if your initial surgeon has destroyed these fibers by creating an extra large breast pocket (to accommodate an extra large implant) and caused your implants to rest below the natural breast crease, you are at risk of bottoming out. Women who have large and heavy breast implants are also at risk, as the sheer weight of larger implants may cause them to slide downward and stretch the tissues by themselves. Those who have naturally small, high breasts and who choose large implants may be at greater risk of bottoming out because there is not sufficient natural space to hold the implants without effectively destroying the fibers responsible for the inframammary fold. This is why expert plastic surgeons often discourage choosing very large implants, especially if you have a smaller frame or naturally smaller breasts. Bottoming out may be prevented by choosing a skilled surgeon and selecting implants that fit your frame and your anatomy. A well-supported bra with underwire can help provide the bottom support needed to minimize your risk of bottoming out after breast augmentation.

How Can I Recognize Bottoming Out?

Since bottoming out typically occurs gradually over time, it may be undetectable at first. You may begin to recognize bottoming out by noticing that your nipple is pointing upward and the upper pole of your breast is collapsing. If you had an inframammary incision for your breast augmentation, you might also see your incision scar ride upward and rest on the middle or lower part of your breast instead of along the breast crease. The skin at the bottom of your breast may also appear to become thinner, allowing you to more easily feel the implant. You should not experience pain with bottoming out, but your breasts may feel heavier at the bottom. If you do experience any pain with the collapse of the upper breast pocket or if you suspect that you are bottoming out, contact Dr. Boyd right away for a consultation about revisionary breast surgery.

How Can Breast Revision Surgery Correct Bottoming Out?

Dr. Boyd performs breast revision surgery to correct bottoming out. During the procedure, he will use sutures and a denuded skin flap to reconstruct your inframammary fold and secure the breast pocket in its proper place. He may also replace your implant with a smaller one to reduce the likelihood of recurrence. To achieve breast symmetry, Dr. Boyd can adjust both breasts and will replace both implants if deemed necessary. After revisionary breast surgery, your breasts will look more natural in their shape, appearance, and position on your chest.

If you believe one or both of your breast implants are bottoming out, schedule your consultation with Dr. Boyd for revisionary breast surgery. To schedule your appointment, call (310) 597-4734 or fill out our online contact form today.