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Breast Implant Bottoming Out | Breast Revision Surgery

Breast Implant Bottoming Out Revision Surgery | Dr Miguel Delgado

Breast Revision Surgery for Breast Implant Bottoming Out

Are your Bottoming Out implants affecting your self-confidence? Can’t stand the pain from your seemingly mispositioned implants? Your breast implants are probably bottoming out and you should consider revision surgery as soon as possible.

Every year, hundreds of thousands of American women undergo breast augmentation surgery. Despite the obvious benefits, some health side effects may creep up for some of these patients – especially if you had surgical complications. One of the most common is issues is the bottoming out of the implants.

What is Breast Implant Bottoming Out?

Breast implant 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.

How Breast Implant Bottoming Out Develops

Breast implant bottoming out can occur on one or both breasts. There’s also no research-backed answer as to how long it takes for bottoming out to happen post-surgery. It could take just a few weeks, months, or even years.

The severity of the condition can also be gauged depending on how much pain and/or discomfort it’s causing the patient, as well as how misplaced the implants appear to be.

Some of the common symptoms of this condition include:

  • Nipples pointed upwards
  • The lower section of the breasts appearing larger
  • The upper section of the breasts appearing narrower
  • Pain and discomfort whenever you touch your breasts

Some of the factors that may put you at a higher risk of getting the condition include a leaking silicone-gel filling, a bust breast implant shell, microbial infection, and hematoma.

Breast Implant Bottoming Out Revision Surgery | Dr Miguel Delgado

Breast implant that has moderate bottoming out

What Causes Breast Implant Bottoming Out?

Each person has their idea of the perfect breast shape and appearance. When considering breast augmentation, choosing the right implants will help you get appealing results without the risk of bottoming out.

There are several causes of breast implants bottoming out. Some of the main ones include:

Lack of Elasticity in the Breast

Bottoming out commonly occurs when the breast implant loses support when the underlying muscle is too week to stay in place. This lack of elasticity in the breast tissue can be due to natural aging, pregnancy, nursing, and dramatic weight loss.

Incorrect Placement of the Breast Implants

You’re more likely to develop bottoming out if your implants were placed directly above a set of muscles. This is a common problem for skinnier patients who typically have limited breast tissue and skin tissue.

An Overly-Dissected Implant Pocket

If the inframammary crease is set too low or the implant pocket is over-dissected, you’re at a higher risk of developing breast implant bottoming out.

Incision Placement

Regardless of the type of breast implants, if they were placed via an incision, they’re more likely to bottom out over time.

What is the Treatment for Breast Implant Bottoming Out?

To treat bottoming out effectively, it is recommended to undergo breast implant revision surgery from a board certified plastic surgeon. Some of the breast implant corrective surgery options include:


Capsulectomy involves the removal of the breast implant, and the tissue capsule enclosing it. It is then replaced with acellular dermal matrix which supports the new position of the implant. The acellular dermal matrix is a human or animal skin which is processed to to make compatible as an implant. This is a very strong matrix and a most effective for giving support.

Open Capsulotomy

This involves making a breast incision to create more capsule space for the breast implant to move freely. It fixes malposition and helps reduce pain. The process may or may not necessitate the replacement of the existing implants.

Autologous Reconstruction

This surgical treatment procedure entails the removal of the old breast implants. It is then followed by reconstructing the damaged breast area using a flap of tissue from a donor area such as the buttocks or stomach.

While autologous reconstruction ensures bottoming out doesn’t reoccur in the future. This is by inhibiting the formation of tissue capsule, it has a long recovery time.

En-Bloc Implant Removal

This procedure is best suited for correcting the bottoming out of silicone gel implants or saline implants. It entails removing the breast implants and intact capsules.

Use of Acellular Dermal Matrix in Patients who have breast implant bottoming out

This breast implant revision procedure is increasingly becoming popular because of how effective it is at inhibiting the recurrence of breast implant bottoming out.

Acellular dermis is a soft connective tissue grafted through a specialized decellularization process. It helps preserve the cellular skin matrix. During breast implantation, this part acts as a scaffold to facilitate subsequent revascularization – the restoration of blood flow. As a result, it corrects bottoming out.

Schedule a Breast Implant Revision Surgery in San Francisco

If you live in the San Francisco area and need expert, safe breast implant revision surgery for bottoming out, reach out to us at Breast Revision San Francisco.

Dr. Miguel Delgado is experienced in correcting unsatisfactory breast implant surgeries and restoring self-confidence. Book a free consultation with us.

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