Q. What is bottoming out of breast implants? Can it be revised?

A. Bottoming out is when the breast implant slips below the inframammary fold as the implant does not receive enough support to remain in the proper position.

Bottoming out is caused if there is an over-dissection of the implant pocket or if the upper epithelium pushes the implant downwards.





One can explain this effect with the image above.

If the original inframammary fold is clear and the implant was placed under the muscle, then it is highly likely to have the bottoming out and the double bubble effect together.

If the original inframammary fold is unclear, and there is no sign of double line effect, the implant slips downwards and the bottom part of the breast mound becomes hard with the upper part loosing volume. This makes the nipple face upwards.



One must first check where the nipple faces in order to diagnose the bottoming out effect. If the nipple points forward, then one can safely state that the implant is in the correction position. If the nipple points downwards, then the implant is pushed upward. If the nipple is facing upwards, then one should be suspicious about the bottoming out effect.

Bottoming out can be caused with the over-dissection from the first breast augmentation and it can also be caused as the implant slips down over time after the breast augmentation.

Less critical bottoming out effect can be treated with the correction bra over 2 to 3 months, but one would require revision surgery for a critical case.
 

Most common revision is the sewing of the capsule under the breast in order to push the implant higher in the pocket. If this is connected with the capsular contracture, the one needs to remove the implant, and remove the skin along the inframammary fold.





The degree of bottoming out effect would determine what treatment method could be applied therefore it is important for you to visit a doctor who is highly experienced.

Today, we looked at the bottoming out effect. Thank you for reading. Have a great day.