Breast Augmentation: Bottoming Out, and Stuff That Isn’t Fun

Breast augmentation and the high demand for beautiful breasts remains one of the most popular plastic surgery procedures in Beverly Hills. With so many breast augmentations, breast augmentation revisions also becomes commonplace. Breast revision surgery may include any number of things ranging from removal and replacement for bigger (or smaller size), capsular contracture (see prior blog for details of this problem), breast asymmetry, removal of saline implants for silicone, rippling, bottoming out, and deflation. Of these, capsular contracture is probably the most common reason for a breast augmentation revision. In cities where bigger is generally deemed as better in the breast worlds (Houston, Dallas, southern California), bottoming out is a rather unpleasant prevalent sequel of large implants. Basically, this is when the weight of the implant causes the implant to migrate down and give an illusion of a nipple to high on the breast. While bottoming out is usually related to larger implants, it can happen to anyone at any age, and a lot of it is related to natural tissue elasticity properties of the individual. That is, smaller implants in a thin girl with poor elastic properties of her skin can also develop this phenomenon. To correct this, one may just wear wired bras for a prolonged period of time if the bottoming out is quick and after surgery, or, may need revisional breast surgery to resuspend the implant above a recreated breast fold. In fact, many of the complications one sees with breast augmentation can be corrected without surgery with good follow up care and compliance. So, every time I plan on performing a breast augmentation on a patient, I stress that THEIR post op care and compliance heavily influences the ultimate cosmetic result. Massaging and attention to post op care by your physician, particularly in the first 6 weeks of surgery is crucial!