Bottoming out is a rare surgical complication that may occur after breast augmentation. Breast revision surgery can correct bottoming out and restore the appearance of the breasts.
What Is Bottoming Out?
“Bottoming out” occurs when one or both breast implants slide below the breast crease. With bottoming out, the upper pole of the breast loses volume, and the nipple and areola point upward. The condition may be associated with double bubble deformity, and the breast may appear to rest on the upper abdomen rather than the chest.
Am I at Risk of Bottoming Out?
Bottoming out only occurs in one or two percent of patients. Patients are at risk of bottoming out if their breast augmentation surgeon over-dissects the tissue or creates a breast pocket in the wrong place within the breast. In some instance, the skin and soft tissues may not be strong enough to support the weight of the implants. This condition is more likely to occur if the implants are situated either too low or too lateral in the breast in relation to the nipple. Some surgeons create a pocket that is too big and destroys the natural fibers of the breast crease, causing it to separate and allowing the implant to slip downward. Patients who have large implants are at greater risk due to the weight and pressure of the implants on the breast pockets. Women with naturally small breasts and large implants are also more likely to experience bottoming out and other related complications due to the lack of natural space for the implants within the breasts. To reduce your risk, choose your breast augmentation surgeon carefully, and select implants that fit your natural breast size and chest wall appropriately.
How Do I Know If I Am Bottoming Out?
Bottoming out often occurs gradually. Over time, the condition can be identified by upward pointing nipples, a collapsed upper breast pole, a heavier lower breast pole, and a poorly defined breast crease. Inframammary scars can also reveal bottoming out if the scars appear higher on the breast instead of along the breast crease. The skin at the base of the breast may feel thinner due to the unbalanced pressure of the implant. Pain or discomfort may or may not be present.
If you believe you may be bottoming out, contact Dr. Schlechter for an in-person examination and consultation for breast revision surgery.
How Can Breast Revision Surgery Help Me?
Breast revision surgery is required for the correction of bottoming out. Dr. Schlechter will tighten and lift the tissues on the underside of the breast and improve the placement of the implant. He will also recreate the inframammary fold (breast crease) in its natural place and tighten the tissues to secure the breast implant so that it does not slip downward again. For some patients, Dr. Schlechter may recommend exchanging both implants for smaller ones to reduce the risk of future bottoming out. During the procedure, he will take care to ensure that the breasts are well balanced and symmetrical in their new position. Breast revision with Dr. Schlechter can resituate the breasts in a more pleasing and natural position with a reduced likelihood of implant shifting in the future.
Dr. Benjamin Schlechter is a board-certified plastic surgeon with a reputation for his low rate of surgical complications following breast augmentation. With over 20 years of experience as a plastic surgeon, Dr. Benjamin Schlechter would be pleased to share his expertise in performing your breast revision procedure to give you the results you desire. To contact Dr. Schlechter about undergoing breast revision, call (847) 737-5036 or fill out our online contact form to request your personal consultation today.