Bottoming Out

Bottoming out is an unappealing condition which affects some breast implant patients due to a variety of reasons. The condition is characterized by implant migration towards the inframammary fold and an abnormally high nipple placement. Surgical correction of this condition is the only effective treatment strategy.

Bottoming Out

Symptoms of Bottoming Out

Symptoms of a bottomed out condition include the sinking of the implant down the chest wall, an unusually high nipple position on the breast mound and a deterioration of the natural (or surgically created) inframammary crease. The appearance of the breast will be strange and unnatural, with the nipple in the upper quadrant of the breast. Frequently, women report overexposure when dressed, since they cannot achieve nice cleavage without risking their nipples being seen. Women who have undergone inframammary augmentation will notice their scars creeping up the breast mound and becoming more visible with time.

Causes of Bottoming Out

Bottomed out implants can occur for several distinct causes. The most common of these reasons includes:

* Surgeon error can create an overly dissected pocket which does not support the implant correctly. This simply means that the space designed to hold the implant is too large and extends too far down the breast interior. This is an example of breast surgery iatrogenesis.

* Subglandular placement in some patients does not allow adequate implant support due to thin breast tissue and skin.

* Inframammary incisions can stretch and cause the degeneration of the natural breast fold, allowing the implant to descend.

* Heavy implants will accelerate normal and expected breast tissue and skin ptosis in many patients, especially in subglandular placements.

* Poorly executed implant placement during surgery. This is commonly a symptom of an inexperienced doctor.

Treatment for Bottomed Out Implants

Surgical revision is indicated for severe cases of bottomed out implants. The procedure varies, but usually includes the removal of the implants and the revision of the pockets. Internal sutures and tissue folding are typically performed to support the implant weight and the inframammary fold might need to be anatomically corrected. Changing implant placement to a subpectoral (good) or submuscular (better) placement will help considerably. Severe bottomed out implants might have caused considerable breast ptosis which might need to be addressed by mastopexy. Once the infrastructure of the breast is reinforced and any external issues addressed, the implants can be replaced in their new anatomical position.

Recommendation on Bottoming Out

This is not a very common condition, but it does occur in some patients. A good surgeon will usually not cause this complication since they are meticulous in surgery and understand the reasons why this defect occurs. However, due to problematic bodily characteristics, bottomed out implants can occur even with the very best operative care. If you are experiencing this annoying and unaesthetic complication, it might be time to consult a cosmetic surgeon for help. Surgical revision requires an experienced specialist who can understand the particulars of why your implants have descended. To learn more about treatment for abnormally low breast implants, consult a qualified plastic surgeon today.

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Bottoming Out to Breast Augmentation, Breast Lift & Breast Implants
12/2/07 Revised 3/8/08