What does it mean when an implant has “bottomed out” and why does it occur?
- The bottom of the breast is much fuller than ideal, with a long distance from nipple to lower breast fold.
- The upper half of the breast is empty
- With the implant dropping down, and because the nipple doesn’t physically move, the nipple is no longer central over the breast mound. Instead, it ends up sitting too high on the breast mound and pointing upwards, and other than just looking odd, this can cause practical problems with areolars visible above the upper end of a bra.
So before we look at what can potentially cause bottoming out after breast implants, a basic surgical concept needs to be explained.
Surgically, when the implant is positioned, the deep aspect of the wound is stitched to form a secure rigid internal support to hold the implant in position, like an internal bra. Dr Dona closes the wound using three internal layers of stitching and this deepest layer is perhaps the most important.
So with this in mind, it follows that bottoming out can occur if this deep stitch layer is poorly performed, or not performed at all.
Or, if this deep stitch layer is not allowed to heal properly. For example, too much inappropriate physical activity too soon can potentially cause this layer to break down.
Other things that can contribute to bottoming out include:
- How heavy the implants are – heavier implants are more prone to dropping
- Smooth implants are more prone to dropping than textured
- Implants placed in front of the muscle are more prone to dropping compared to those under the muscle
- The quality of the person’s breast tissue and skin – breast tissue that’s soft and thin is less capable of supporting an implant
- Not wearing appropriate supportive bras to support the weight of your breast implants
- Or any combination of these issues
So, if you develop bottoming out after breast implant surgery, this can be an extremely difficult problem to fix, and the underlying cause will need to be determined. Of course, a skilled and experienced plastic surgeon should be able to address this problem.