There really is a whole new language to learn in the world of breast implants (read my article on breast augmentation language here)!
You will hear all sorts of new words, especially when talking about possible breast augmentation complications. Like... what is 'bottoming out'?!
Before I explain what bottoming out is, let me take you back to a basic explanation of a breast augmentation recovery.
Breast Augmentation Recovery
After a breast augmentation, breast implants 'ride high' on your chest and they take their time (through a process called 'drop and fluff') to settle down into a natural position in the breast pocket.
If there is not enough support (I'll go in to the reasons why in a minute) your breast implant can continue to travel south and if it drops too far that's bottoming out.
What is Bottoming Out?
Bottoming out occurs due to lack of support of the breast implant. Support from your body that is, not bra.
It's your breast implant going south of the border.
So, a bottomed out breast implant will sit below your natural breast fold. A bit like this...
Basically, it looks like your real breast is still there, and that the breast implant dropped below it. And it's easy to see from the front because your nipple looks too high on your breast, but it's easiest to see from the side...
...as your nipples point skyward. This is because the breast implant slipping increases the distance between the bottom of your nipple and the bottom of your breast fold.
What Causes Breast Implant Bottoming Out?
The skin in your breasts is pretty neat... it will stretch to accommodate your breast implants. BUT a breast implant can bottom out if:
The pocket your breast implant is in is over dissected (cut too big) - the breast implant can push down too much inside.
Your natural breast fold was lowered by your plastic surgeon - inside your breast, your inframmary fold is attached to your rib cage (giving you that natural under boob contour). If this disrupted there is no support for your breast implant and it slips below the crease.
Your breast implants are too large for your body - the weight of a heavy breast implant can push it under the breast fold. The smaller you are, and the bigger your breast implant, the greater your chances of bottoming out.
How Will I Know If My Breast Implants Have Bottomed Out?
Definitely don't try and diagnose yourself! If you are ever worried about the look or feel of your breast implants consult with your surgeon.
BUT there are a couple of signs which could suggest you’ve bottomed out:
Your scars (if you got a crease/underboob/inframmammary incision) may travel up from the crease to the lower pole of your breast
If your nipples have moved up your breasts and are pointing skyward
Can Bottoming Out be prevented?
By you? No. Bottoming out cannot be prevented by anything you do or don't do. So, there is no magic bra!
Sometimes it's just down to your body's tissues and the actions of your plastic surgeon.
Which is why it is so important to ensure you choose a Board Certified surgeon, with heaps of breast augmentation experience, that you listen to their guidance on implant size and follow their post-op instructions.
If it's going to happen it's going to happen, but it's still good to make sure you don't do anything to put any undue stress on the bottom of your breast pockets as you're recovering.
How Is Bottoming Out Fixed?
A bottomed out breast implant will not go back up on its own. So the only way to fix it is with surgery.
Bottomed out breast implants require revision surgery to remove the breast implants, repair the lower part of your breast pocket using permanent stitches (often using a special kind of material called a 'dermal matrix' to strengthen the area) and then replace with smaller breast implants.
Breast Implants typically take at least 6 months to settle after a breast augmentation. If your breast implants do bottom out you will need to wait at least 6 months (and up to a year) after your first breast augmentation before considering a revision.
Now I know the part you'll focus on there is SMALLER IMPLANTS! Any downsize in breast implants to repair bottoming out is often only temporary. If everything heals up good after a revision for bottoming out you can remove and replace again with larger breast implants - but not for at least a year.
It's important to know what to expect from your breast augmentation so you can identify if things are not going well. If you see any signs of your breast implants going too far south, and you suspect bottoming out, consult with your plastic surgeon.
Your breasts should make you look and feel good and you can totally own this part of your breast implant journey :)
Thoughts from Dr. Michelle RoughtonBottoming out can occur for a variety of reasons.
Careful technique during the augmentation is certainly a key in preventing it from happening, as is making sure that the implant size that best fits your body is selected.
It can be corrected in several different ways, and we have found that a dissolving mesh product, such as Galatea, does a great job serving as sort of an internal bra to help better position your implants if you find that they have bottomed up and are interested in a revision.