Breast Augmentation and Implants Bottoming Out

Breast augmentation is becoming more and more popular as individuals seek to achieve perfect curves and the ideal swimsuit body. Women who are born with naturally small breasts or who find their tissue has shrunk after having babies or nursing often turn to cosmetic surgeons.

Like all cosmetic procedures, this one carries a measure of risk. Common risks may include capsular contracture, a condition where a scar forms around the implants causing an unnatural appearance and the potential for pain, implant ruptures or leaks, infection, swelling, and rippling appearance. Another possible complication is having the implant bottom out.

There are several causes of this breast augmentation complication. It usually occurs when the tissue that supports the bottom of the breasts weakens, forcing the implants to move down towards the bottom of the rib cage. The reason the tissue weakens can include too much dissection of the implant pocket, an implant that is too heavy for the patient's anatomy, or the general placement of the implant.

If the implant pocket is over dissected, the implant will bottom out within a few weeks or months. When the implant is too heavy for the tissue to support, the problem will show up gradually over time. In this case, the woman might not notice the issue is happening right away because of the gradual decline. 

In the instance of placement issues, sub-muscular placement has the least risk of bottoming out. When the implant is placed above or in between the muscles, the risk of bottoming out is greater. However, placing the implant below the muscle makes the results slightly less natural in appearance, so patients will need to weigh their options with their doctor before making a final decision.

While the sight of an implant laying low in the chest may be discouraging or even frightening to a woman who has this problem, fixing it is fairly straightforward, although somewhat complicated for the surgeon. All the breast augmentation patient needs to do is re-visit her surgeon. The surgeon will then re-open the surgical area, typically making an incision along the patient's natural crease. From there he will cut the tissue around the implant and roll it up toward the position where it should be, securing everything in place with internal sutures. The incision is then closed and the patient faces recovery again.

So how can a woman who is interested in breast augmentation prevent this complication? While it may be impossible to prevent for every patient, some steps can help. First, choose your surgeon carefully. The more skilled the surgeon is, the less likely the chance that he will incorrectly position the implants and leave you at risk for this complication. Second, follow your physician's instructions carefully. This applies in particular to implant size. A woman who asks her surgeon to place implants that are far too large for her greatly increases her risk of this problem. Finally, wear your supportive bra as instructed by your surgeon after your procedure. This will help prevent the pull of gravity from negatively affecting your breasts.