What Is Bottoming Out with breast implants?
By Dr. Aaron Gilson, Gilson Plastic Surgery, Portland, Oregon
Breast augmentation is a transformative procedure for many women, offering enhanced confidence and a more pleasing aesthetic. However, like all surgical procedures, it comes with certain risks, one of which is 'bottoming out'. As a plastic and reconstructive surgeon at Gilson Plastic Surgery in Portland, Oregon, my aim is to educate and guide patients through their journey in cosmetic surgery. In this comprehensive guide, we'll explore the phenomenon of bottoming out, a concern for some patients undergoing breast augmentation.
Defining Bottoming Out in Breast Augmentation
Bottoming out is a term used to describe a condition where the breast implants descend too low on the chest wall, leading to an unnatural appearance. This occurs when the implants slip below the natural crease of the breast (inframammary fold), causing the nipple to appear too high on the breast and the lower pole of the breast to be overly stretched. The condition can affect one or both breasts and can alter the aesthetic outcome of a breast augmentation surgery.
Causes and Risk Factors
Understanding the causes and risk factors is crucial in addressing bottoming out:
Surgical Technique: Inappropriate pocket dissection or placement of the implant can lead to inadequate support for the implant.
Implant Size and Weight: Larger, heavier implants increase the gravitational pull, potentially stretching the skin and tissues and leading to displacement.
Tissue Characteristics: Patients with weaker or less elastic breast tissues, often due to age or genetics, may be more susceptible to this condition.
Postoperative Care: Failure to adhere to postoperative care instructions, such as wearing a supportive bra, can contribute to the risk of bottoming out.
Prevention and Treatment Options
Preventing and addressing bottoming out involves several strategies:
Surgical Prevention: During surgery, careful pocket dissection, appropriate implant selection, and correct placement are crucial in minimizing the risk of bottoming out.
Supportive Garments: Post-surgery, wearing a well-fitted, supportive bra can help in maintaining the position of the implants.
Revision Surgery: If bottoming out occurs, revision surgery may be necessary. This can involve techniques such as creating a new pocket for the implant, using sutures to re-establish the inframammary fold, or utilizing acellular dermal matrices to provide additional support.
Follow-up Care: Regular follow-up appointments after surgery allow for early detection and intervention if bottoming out is suspected.
What to Do If You Suspect Bottoming Out
If you suspect your breast implants have bottomed out:
Consult Your Surgeon: It is crucial to schedule a consultation with your surgeon. They can assess your situation and recommend the appropriate course of action.
Photographic Documentation: Taking photos can help in tracking any changes in breast appearance over time, which is useful during consultations.
Consider All Options: Discuss with your surgeon all the possible treatment options, their benefits, and risks.
At Gilson Plastic Surgery, we are committed to ensuring the best outcomes for our patients. We understand that the journey does not end at the operating table but continues through recovery and beyond. Educating patients about potential risks like bottoming out and how to address them is part of our comprehensive approach to patient care.
-Dr. Aaron Gilson
Gilson Plastic Surgery
Portland, Oregon