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What is bottoming out

With bottoming out, the breast implant moves downwards forcing the visible bottom crease of the breast to appear lower on the chest. It appears as though the bottom of the breast has dropped. Factors influencing the cause of bottoming out include:

• Over dissection of implant pocket
  When this is the cause, bottoming out usually occurs within weeks or months of breast enlargement surgery.


• The implant is too heavy for the amount of skin and underlying breast tissue
  In this case, bottoming out usually occurs gradually over time.


• Placement of the breast implant
  Complete submuscular implant placement (full unders) results in a much lower risk of bottoming out than with subglandular (overs). With unders, the breast implant is positioned in a pocket of muscle tissue and so it is more firmly supported than with overs where the implant is supported only with fatty breast tissue and skin.

Correction of Bottoming Out

Corrective surgery is necessary. The tissue surrounding the implant is cut and rolled upward to the desired position of the new crease and held in place with internal sutures. If the breast implants were originally positioned using the subglandular placement, then a submuscular placement may be used for the corrective surgery. If the breast tissue is not firm enough to support the current size breast implant, then a smaller implant may be needed instead or it may be temporarily removed while the breast tissue heals and firms.