Bottoming out is a condition whereby a breast implant slips below the natural line crease underneath the breast, and the nipple appears higher than where the implant has fallen. This condition is very predominant in women who are very thin and essentially have very little breast tissue. Bottoming out also happens when an implant has been placed above the chest muscle.
How Does Bottoming Out Happen?
During breast augmentation, bottoming out happens when the implant pocket is overly dissected. It can also occur when the inframammary crease is set too low during the first operation.
Also these mistakes are seen more in inexperienced surgeons. Veteran surgeons are known to make a different type of mistake by inserting an implant that is too large which causes stretching of the skin. Eventually a pocket forms below the implant creating space for the implant to slide into.
Most cases of bottoming out are reported within a few months; however, if it forms years later, then it may be as a result of an implant that was too heavy. It is more common in breast implants that were inserted through the armpit, inframammary and periareola incisions.
Is it Specific to One Type of Breast Implant?
Bottoming out can happen with any kind of implant whether it’s saline or gel, textured or smooth, and tear or round drop.
Can It Be Corrected?
Luckily, bottoming out is a condition that can easily be corrected with the help of a certified and experienced surgeon. You can check whether your plastic surgeon is certified or not through a quick check through the database of the Australian Society of Plastic Surgeons.
Below are different procedures that are used to correct bottoming out:
1. Implant replacement. This procedure involves closing the pocket and replacing the old implant with a new one.
2. Capsulorrhaphy. This involves placing sutures in the lower half of the breast. The capsule holding the implant is then adjusted while the position and size of the implant is adjusted. This will make it sit higher on the chest.
3. Breast lift. This is a form of plastic surgery whereby the patient’s breast is lifted in order to give it a more youthful look. In this case, if a patient’s breast has bottomed out, and her skin has lost its elasticity, a breast lift will help correct the condition.
Corrective surgery for bottoming out will usually take anywhere between one to three hours. The length of the procedure will depend on the amount of reconstructive work that needs to be done. Patients can recover anywhere between four to six weeks, and can resume their normal activities within a week of the surgery. However, it is advised that the patient avoids strenuous activities for at least 10 days and should wear a reconstructive bra for up to six weeks.
Bottoming out should not be cause for alarm for patients who are experiencing it. Simply contact your surgeon, and arrange for reconstructive surgery to be done. You might prefer seeking a more experienced surgeon as opposed to the surgeon who performed the initial operation.