Correction of Bottoming Out -Inferior Displacement of Breast Implants

Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. It is the loss of internal implant support where implant placement with partial, or no, muscle coverage, allows slow downward migration of the implants. This is because support of the implant by the skin alone is not always enough to prevent downward migration of the implants. Also, over-dissection of implant pockets at the time of surgery may cause immediate bottoming out. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.
This patient had the "internal bra" - which refers to the internal suturing of the pocket to achieve bettery placement of the breast implants.

The Surgical Procedure

The operation time varies depending on what exactly would need to be performed. We will review this with you after you have been examined by Dr. Pousti.

For correction of bottoming out, the procedure can take from 1-3 hours depending on how much work is involved. Board Certified Plastic Surgeon, Dr. Pousti takes his time in the operating room to make sure that he does what he can to achieve the patient's results. Usually an internal suturing technique is used to correct the pocket and therefore the implant placement on the chest.


What To Expect After Surgery

Pain is rarely strong, more commonly being a degree of discomfort. Swelling occurs but usually begins to subside by the third or fourth day. Some degree of swelling may persist for longer periods. A well-fitted bra is worn day and night for three weeks. While there is probably seldom interference with future breast feeding, women are cautioned that it may not be possible to breast feed in the future.

The surgical bra is used to stabilize the area after the repairs are made.

Resumption Of Physical Activities

Driving may be resumed in 1-2 weeks.
Non-contact sports in 3 weeks.
Contact sports in 6 weeks.

Testimonial:
I LOVE my new breasts!!! Dr. Pousti is the BEST Plastic Surgeon EVER!! I had my saline breast implants placed 4-5 years ago and with time, my left breast implant became displaced (bottomed out). You could see the difference in the breast implants when I wore tank tops or anything tight. I finally decided to get them fixed when I saw myself in a bikini and saw the difference between the 2 breasts. Since I was going to have the revisionary breast surgery to fix the breast pocket, I decided to exchange my saline implants to silicone gel implants and increase the size of my implants a little. The staff was wonderful and took great care of me! Since Dr. Pousti has an office in La Jolla, it is very convenient for me to have my check-up's. I feel like the best plastic surgeon took care of me and I look WONDERFUL!! It's only been 2 weeks and I hear it's only going to get better.

If you are considering revision breast surgery and are located in or around La Jolla, Riverside or San Diego, we invite you to contact Dr Pousti and arrange for your personal, confidential consultation.

Tour our site to learn more about breast revision in San Diego, Riverside and La Jolla. Read testimonials from breast revision patientsof Board Certified Plastic Surgeon Dr. Tom Pousti. View before and after photos of revisional breast surgery patients,and send your questions directly to the offices of Southern California Breast Revision Specialist Dr. Pousti through our contact form.