A small number of women do not receive optimal results their first time with breast augmentation surgery and require additional procedures to correct positioning, size, shape, or overall aesthetics. One of the more common complications from a breast augmentation is “bottoming out.” As a female surgeon, Dr. Lavinia K. Chong has over 20 years of experience with the female body and is skilled at performing bottoming out revision surgery in Newport Beach to address issues from previous breast procedures.

What Exactly Is Bottoming Out?

Bottoming out is a breast augmentation complication that happens when one or both of your breast implants slip below the breast crease. The breast crease refers to the portion of your chest where the bottom of your breast meets the rest of your body. If you are experiencing bottoming out, you may notice:

  • Increased fullness in the lower breast pole
  • Nipples that tilt upward
  • Bulging below the breast crease
  • Increased visibility of the scar line typically hidden within the breast fold.

What Are the Causes of Bottoming Out?

While bottoming out is a rare complication after breast augmentation, some factors may make breast augmentation patients more susceptible to it. These causes include:

  • The Breast Implant Pocket is Too Big.

During a breast augmentation surgery, the surgeon creates a pocket in your breast tissue where the breast implants will be placed. Sometimes, the breast pocket can be over-dissected or made too large, putting patients at risk of bottoming out.

  • Your Breast Implant is Too Big or Too Heavy for the Amount of Breast Skin You Have.

Bottoming out may occur when patients get implants that are too big or too heavy for their bodies to support. As a female plastic surgeon, Dr. Chong understands that when it comes to selecting a breast implant size, some women want to go big. One of the advantages of working with her is that she is always honest, and she will tell you if your desired breast implant size will work with your anatomy.

  • You Had Your Breast Implants Placed Above the Muscle.

While many women choose to have their breast implants placed above the muscle, the location of this placement does put you at risk for bottoming out. A breast implant that is placed under the breast muscle is less likely to develop this complication.

What Do I Do if I Am Bottoming Out?

If you think you are experiencing this complication, Dr. Chong can evaluate you at her Newport Beach practice and determine if you are indeed bottoming out. She will create a personalized breast revision surgery plan for you and select the appropriate techniques based on your specific case and anatomy. These techniques may include:

  • Tightening up the breast implant pocket
  • Exchanging your current breast implants for others that are an appropriate size for your anatomy
  • Placing your breast implants under the breast muscle

How Does Breast Revision Surgery Correct Bottoming Out?

Breast revision surgery in Newport Beach offers proper support for breast implants and secures them into place. Specifically, Dr. Chong uses a reconstructive tissue matrix known as Strattice that functions as a sling to lift and support the implants. In other words, this Strattice functions as an “internal bra.” The Strattice is sutured to the free edge of the muscle and eventually fuses with the native breast flap to strengthen weakened tissue and reinforce the breast pocket. This technique can be used with both saline and silicone implants up to 500 ccs.

Revision breast surgery is performed under anesthesia to maximize your comfort, and our team will closely monitor your vital signs for safety. During surgery, Dr. Chong will place a drain to prevent fluid collection between the Strattice and the breast flap and promote revascularization. The drain is typically removed after three days as healing continues. Dr. Chong will carefully evaluate your progress to reduce the risk of complications. You can resume many of your normal activities within several days but should avoid upper body workouts for several weeks as new tissue grows around the Strattice mesh.

Before surgery, Dr. Chong will walk you through the procedure and recovery so that you know what to expect and can prepare accordingly. Breast revision surgery can effectively correct issues following breast augmentation and provide you with more flattering results that complement your figure.

Frequently Asked Questions About Bottoming Out

  • Can bottoming out be fixed without surgery?
    • Due to how the breast implant has shifted, and the loss of internal support from weakened skin and muscles surrounding it, revision surgery is the only option for correcting bottoming out. The implants must be appropriately repositioned and supported to maintain the desired profile, shape, and aesthetics. In some cases, we may need to reduce implant size or create a new pocket, which can only be performed surgically.

      Breast revision surgery can also help prevent future bottoming out or malposition of breast implants. Dr. Chong considers the weight of the implant, whether it was placed above or below the pectoral muscle, and your lifestyle and level of physical activity when determining how to achieve a lasting, desirable outcome.

  • Does bottoming out cause pain?
    • Bottoming out is typically not painful, but as the implant shifts downward, you may feel pressure in your lower chest, or your breasts may feel heavier because the implant has less support. The effects of bottoming out are more visible than physical. You will be able to see that your nipple is pointing upward, your areola appears higher on your breast, and your breast appears unbalanced, with the lower portion bulging below the breast crease. If you had an inframammary incision, the scar might be visible above the breast crease because the implant has shifted down and altered how the skin naturally lays. Bottoming out may also only occur in one breast, creating a visible distinction between how your breasts look.
  • How can I prevent bottoming out?
    • There are several steps you can take to reduce your risk of bottoming out. The first is to choose a qualified surgeon with extensive knowledge and experience regarding breast augmentation surgery, including risk factors that may affect implant results. Be open and honest regarding your medical history, lifestyle, and other factors so that your doctor can develop an appropriate surgical plan.

      Two significant factors in bottoming out are the placement and weight of the implants. Positioning the implant under the pectoral muscle can offer more support than placement on top of the muscle. In addition, implants come in varying textures, shapes, sizes, and densities, so find a happy medium that provides you with the look you are aiming for while also creating balance with the rest of your body. Lastly, follow all post-operative instructions to allow your body to heal and adjust to your new breasts.

Schedule a Consultation Today

You do not need to live with this complication if you think your breast implants are bottoming out. As a female herself, Dr. Chong understands the desire to be happy with your overall appearance. With her guidance, you can get beautiful results that you will be pleased with for years to come.

If you think your breast implants are bottoming out, know that you do not need to live with this complication. To schedule your initial appointment with Dr. Chong, contact our Newport Beach office today online or at (949) 644-1400.