Breast Augmentation Revision – Bottoming Out

Posted May 30, 2015 in Breast Asymmetry, Breast Augmentation, Breast Implant Revision Surgery, Home

Bottoming Out is when breast implants settle lower on the chest than desired. It is a form of Breast Implant Malposition also called inferior malposition.

Breast Implant Revision Surgery Before and After Pictures
Bottoming-Out Correction

<b>Severe Bottoming-Out</b>: Breast implant revision surgery before and after pictures of the correction of severe bottoming-out with an internal lift. No additional exterior incisions were needed to provide correction.

Severe Bottoming-Out: Breast implant revision surgery before and after pictures of the correction of severe bottoming-out with an internal lift. No additional exterior incisions were needed to provide correction.

Breast Implant Malposition

Malposition literally means “Bad Position,” and it is a generic term applied to any situation where the breast implant is not in its ideal position. Breast Implant Malposition can be too high (superior) or too low (inferior) like Bottoming-Out. In can also be too far to the side (lateral) or too close to the middle (medial) also known as Symmastia, Uni-Boob or Bread-Loafing.

Breast Implant Revision Surgery Before and After Photos
Bottoming-Out Correction Side View

Severe Bottoming-Out: Side view of breast implant revision surgery for severe breast implant inferior malposition and lower pole rippling. Correction was obtained with an internal capsulorrhapy and no addition exterior scars.

Severe Bottoming-Out: Side view of breast implant revision surgery for severe breast implant inferior malposition and lower pole rippling. Correction was obtained with an internal capsulorrhapy (pocket tightening) and no additional exterior scars.

Correction of Bottoming-Out

Breast Augmentation Revision Surgery is used to correct problems with Breast Implant Malposition, and there are several methods for correcting bottoming out. The most common methods tighten and reinforce the lower pole of the internal capsule, which supports the implant. When the lower capsule is stretched out, the breast implant falls. Tightening the pocket raises the implant on the chest. If the capsule is too weak to repair primarily, reinforcement with a surgical scaffold like an acellular dermal matrix (Allo-Derm, Statice and others) or Seri, may be helpful. If the problem is that the skin can’t support the weight of the implant, a smaller implant may be a good compromise.

Breast Implant Revision Surgery Before and After Photos
Mild Bottoming-Out Correction with Nipple Reduction

Mild Bottoming Out: Most the volume of the breast implant is below the nipple before the breast implant revision surgery. Note the enhanced fullness above the nipple and the improved angle at the bottom of the breast. Nipple reduction was also performed.

Mild Bottoming Out: Most the volume of the breast implant is below the nipple before the breast implant revision surgery. Note the enhanced fullness above the nipple and the improved angle at the bottom of the breast. Nipple reduction was also performed.

Mild Bottoming-Out and Large Nipples

Even mild Bottoming-Out can cause problems. In the case below, the obtuse angle underneath the breast made finding a comfortable bra difficult. The open angle allowed the bra to ride up on the breasts. After Breast Augmentation Revision Surgery, the infra-mammary fold under the beasts is crisp and well defined, allowing the bra to engage properly. It also provides enhanced fullness to the upper pole of the breast. Additionally, she complained about large nipples that were easily visible through clothing. Nipple Reduction Surgery was performed at the same time as the correction of her bottoming-out.

Breast Implant Revision Surgery Before and After Pictures
Mild Bottoming-Out Correction and Nipple Reduction

Mild Bottoming Out: The breast implant was too low before this breast revision. The breast implant volume was moved from below the nipple to a more centralized position, providing enhanced upper breast fullness, and a sharper infra-mammary fold under the breasts. Nipple reduction surgery was performed at the same time.

Mild Bottoming Out: The breast implant was too low before this breast revision. The breast implant volume was moved from below the nipple to a more centralized position, providing enhanced upper breast fullness, and a sharper infra-mammary fold under the breasts. Nipple reduction surgery was performed at the same time.

Breast Augmentation Revision Surgery

When considering Breast Augmentation Revision Surgery be certain to find an experienced and Board Certified Plastic Surgeon near you. Dr. Joseph Mele, is Board Certified by both the American Board of Plastic Surgery and the American Board of Surgery.

To schedule a private consultation with Dr. Mele call (925) 943-6353 today, or use the contact form in the margin.