Bottoming out is a complication that can result after breast augmentation surgery. This occurs when the breast implant moves below the breast crease, resulting in a “bottom heavy,” unnatural appearance that must be corrected with breast revision surgery.

Characteristics of Bottoming Out

  • Nipples positioned too high on the breasts
  • No fullness at the top of the breasts
  • Breasts feel and appear “bottom heavy”
  • Breast augmentation scar may ride upward out of the breast crease
  • Occurs slowly over time

Causes of Bottoming Out

Bottoming out is more likely to occur when the breast pocket that holds the implant is positioned too close to the breast crease during surgery. It is also more of a risk in patients who have naturally small, high breasts or who lack an adequate amount of breast tissue to support the implants. Very large implants or poor tissue quality can contribute to the likelihood of bottoming out.

Preventing Bottoming Out

While this complication can occur even at the hands of a very experienced surgeon, choosing a surgeon who is board certified and highly experienced in performing breast augmentation will help reduce the risk of bottoming out. Choosing an implant size that will coordinate well with your frame and amount of breast tissue will also help with prevention. Dr. Doezie will review all of these factors as well as your goals for the procedure during your initial consultation for breast augmentation to determine the best surgical approach to prevent complications like bottoming out.

Correcting Bottoming Out With Breast Revision

Bottoming out can usually be corrected with a capsulorrhaphy, which involves sutures and sometimes acellular dermal matrices (soft tissue grafting) to strengthen the tissues in the lower part of the breasts. This will elevate the implants to the correct their position and provide enough support to keep them there. Usually, smaller implants are used to prevent the complication from re-occurring, but the need for this will be determined on a patient-by-patient basis. Recovery from this procedure is similar to that of breast augmentation; most patients plan for about two to three weeks off from work and strenuous activities. After breast revision surgery for bottoming out, patients are typically very satisfied with their long-lasting results which include more youthful, natural-looking breasts and increased confidence.

If you are interested in breast revision surgery with Dr. Allen M. Doezie, please schedule a consultation by calling 949.481.9850 or by filling out our online contact form.