Bottoming out 

After breast surgery

Bottoming out: Causes and Treatment Options

"Bottoming out" refers to the shifting or slipping of breast implants downwards, while the breast tissue does not move. The lower part of the breast, and especially the skin, is greatly stretched by the shifting of the breast implant. This downward shift of breast volume pushes the nipple further upward into an unnatural position. Additionally, the distance between the nipple and the inframammary fold (the crease below the breast) increases.

Learn about when and under what circumstances bottoming out occurs and how a surgeon can reposition once slipped breast implants to their proper position on the following pages.

When can bottoming-out occur?

The occurrence of bottoming out after a breast surgery, such as breast augmentation, can have different causes. If the phenomenon is already noticeable a few weeks after the breast augmentation and the placement of the implants, it is likely that something did not go optimally during the breast surgery:

  • Implant pockets / implant cavities were created too low / incorrectly: When inserting breast implants, the surgeon forms a pocket or cavity in which the breast implant is then placed. If this pocket / cavity is too large for the implant or not correctly positioned, the risk of the breast implant slipping after the breast surgery increases, among other things because it can be pushed down by the chest muscle. This is especially the case if the implant was placed on the chest muscle (submuscular) rather than under the chest muscle (subglandular).

  • Larger and heavier breast implants are more likely to make their way down than smaller and lighter ones.

  • Too short recovery time / no rest after breast surgery: After breast augmentation, both athletic activities and lifting heavy objects, jerking the arms and excessive strain on the chest muscles should be avoided. Surgeons also recommend their patients to wear a compression bra after breast surgery. If these recommendations are not followed, the breast implants will not heal properly. The consequences will then also manifest in a bottoming out.

  • There is already more or less pronounced weakness of the tissue and / or muscle, which was not taken into account in the choice and positioning of the implant.

On the other hand, if bottoming out occurs a few years after the breast augmentation, the natural aging of the skin and thus the loss of tension in the tissue can be the cause of the downward slipping of the breast implant.

Causes Bottoming Out

Ultimately, the implant loses support from the weakening tissue structures. The muscles become weaker, and the supporting tissue slackens. The implant can no longer be held in place by its own internal forces and slips down.

How can bottoming out be corrected

Depending on the extent of the bottoming out, a correction surgery of the breasts may be the right decision.

In this case, the surgeon may choose a smaller and better-fitting implant for the existing implant pockets. In some cases, it may also be sufficient to reposition the existing breast implant, for example on the chest muscle if it was previously under the chest muscle.

It is also possible and may be necessary to remodel the implant pockets and perfectly adapt them to new or existing implants.

In addition, the surgeon can also perform a skin tightening during this breast surgery by removing excess tissue and/or skin. A reinforcement of the lower breast fold/fixation of the breast fold can also be performed or a strengthening and support of the (supporting) tissue.

Bottoming out correction in Munich

The method of treatment that is appropriate in your specific case of bottoming out, whether it is indeed a bottoming out, and when each treatment step should be initiated, I will discuss as an experienced expert in plastic and aesthetic surgery with a modern practice in Munich, gladly personally with you.

Outstanding specialist in plastic & aesthetic surgery

Over 6000 surgeries -
experience from practice & continuing education

In a personal appointment, I will advise you on an individual basis. Make the most of your type. I look forward to seeing you!