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Unhappy with your breast implants?

Consult with one of San Francisco’s Top Doctors, board-certified plastic surgeon Miguel Delgado Jr. M.D. Correcting aesthetic and medical complications due to problematic breast augmentation surgeries is one of his specialties. Read about the main surgical techniques he employs in breast implant replacements, watch videos of the doctor and patients to know what to expect, and view actual patients before and after photos to evaluate the results.

Bottoming Out

bottoming-out-1 “Bottoming out” describes the condition of a breast that is bottom heavy.The breast implant should be the target and the nipple-areolar complex should be the bull’s eye- or slightly above the mid-point. Bottoming out occurs when this balance is altered, with the breast implant lower and thus the nipple-areolar complex appears high.

While the causes of bottoming out are many, some of the more common are:

  • the breast implant stretches out the tissue below the nipple-areolar complex.
  • poor quality skin which stretches easily.
  • a surgeon dissecting the lower breast pocket too low during placement of the breast implant.
  • when the breast implant is placed concurrently with a breast lift procedure (mastopexy), over time, the skin can stretch.

Treatment of bottoming out is to re-establish the bottom support of the breast. This requires breast revision surgery. The skin must be sutured down and upward so that the distance between the nipple-areolar complex and the breast fold is reduced to the appropriate length. This will hold up the breast implant to the proper position, creating a better relationship to the nipple-areolar complex. A variety of suture techniques exist to hold the implant in position.

Bottoming out of the breast means a troublesome breast deformity. Breast revision surgery requires a surgeon with in-depth knowledge and extensive experience to successfully improve the deformity.

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