“Bottoming out”
Bottoming out refers to a condition where the breast implant moves below the breast crease. The breast appears “bottom heavy” and the nipple appears to be high. There is also a loss of superior breast fullness, causing the breast to appear less youthful and more matronly, with a long upper chest and breasts that appear to be sitting on the upper abdomen. The appearance is unattractive.
Bottoming out occurs for several reasons. Probably the most common causes are the use of an implant that is too large and the cutting of the chest muscle at the breast crease during surgery. When an overly large implant is used, there may be no place for it to fit other than below the breast crease. When the muscle is cut, it removes a support structure for the breast implant. Over time the implant moves down with gravity.
Another common cause of bottoming out is the placement of large, heavy implants above the muscle when there is breast ptosis, or sagging. This can lead to a “rock-in-the-sock” deformity.
The solutions for this complication usually involve securing the implant in an elevated position where it should be and a procedure that fixes the new breast crease with a suture technique. A smaller implant is often advisable, if the original one is too large. A support bra will also help maintain optimal breast implant position and breast shape.
