Prevention and Correction of “Bottomed Out” Breast Implants

The entire reason for undergoing breast augmentation surgery is to improve the appearance of the breasts. Patients want to boost their confidence about and enhance the way they look.

Unfortunately, in some cases, patients may not get the results they desire. Pregnancy, weight gain or loss, initial implant misplacement, or the natural effects of aging may cause the implants to shift out of position or change in shape. Under these circumstances, patients may have to undergo breast revision surgery to tighten the breast pockets and produce an ideal aesthetic.

The Causes of Implant Displacement

Implant displacement, bottoming out, or double-bubble may occur as a result of a misplaced or an overly large implant pocket. Bottomed out implants and double bubble refer to implants that sit too low on the chest. During a breast augmentation procedure, the implants are deliberately placed a bit higher than the desired position. Within a few months, the implants will settle into the ideal position.

However, implant displacement may occur if the pocket is too low or too large. This will cause the implants to fill out the lower half of the breasts, making the nipples appear as though they are located too high on the chest.

To prevent bottoming out of breast implants, patients should choose a board certified plastic surgeon who is skilled in the breast augmentation procedure.

Bottoming out may also occur if the breasts simply do not have enough tissue to support the implants; this is most often the case in women who choose to have excessively large breast implants placed or those who have genetically weak tissues.

Another contributing factor may include failure to wear properly supportive bras following the initial surgery. Many surgeons will recommend that patients only wear surgical bras for the first month following surgery. This will help support the breasts and encourage the skin to conform to the new contour while the implants settle into their proper location.

Correction of “Bottomed Out” Implants

The surgical correction of bottomed out breast implants may involve different techniques.

Capsulorrhaphy: To elevate the breast and restore a normal appearance, sutures may be placed in the lower pole of the breasts. The capsule that holds the implant is adjusted, and the position and size of pocket is tweaked so the implants sit higher on the chest.

Implant replacement: After the capsule has been corrected, the surgeon can place a new implant in the pocket.

Breast lift: If the patient has developed significant skin laxity, breast lift techniques may be performed to tighten the skin envelope and move the nipple up higher on the breast.

Breast implant revision surgery to correct bottomed out breast implants generally takes anywhere from one to three hours, depending on how much reconstructive work is needed. Recovery is usually quite minimal, but patients will be required to compress the breast skin with an ACE-type bandage and wear surgical bras for four to six weeks following the procedure.

Of course, all patients want their initial breast augmentation procedure to be a success. When this is not the case, there are ways to correct the problem. Contact Crawford Plastic Surgery to learn more about the breast implant revision options available to patients.