Bottoming out?? What options are there to fix it??

Hi Guys,

I'm seeing my ps on Tuesday as I am convinced I have bottomed out in my left breast. I have a couple of questions for you. Have any of you thought you were bottoming out but your surgeon thought you was fine?? What is the next step if they feel there isn't a problem?? If they do agree to a re-op, what options are they for fixing it. I know somebody has suggested going from overs to unders. Is this something they do consider or do they just fix the bad boob??

It's my left that is visibly lower than my right, but even my right doesn't have the fullness and roundness at the top that I desired from this op. Would he look at both or just the one?

Sorry, so many questions and I know probably only my ps can really answer but any of your experiences shared would be appreciated.

Thank you,

Sharon.x

Symptoms of a bottomed out condition include the sinking of the implant down the chest wall, an unusually high nipple position on the breast mound and a deterioration of the natural (or surgically created) inframammary crease. The appearance of the breast will be strange and unnatural, with the nipple in the upper quadrant of the breast. Frequently, women report overexposure when dressed, since they cannot achieve nice cleavage without risking their nipples being seen. Women who have undergone inframammary augmentation will notice their scars creeping up the breast mound and becoming more visible with time.

Causes of Bottoming Out
Bottomed out implants can occur for several distinct causes. The most common of these reasons includes:
* Surgeon error can create an overly dissected pocket which does not support the implant correctly. This simply means that the space designed to hold the implant is too large and extends too far down the breast interior.

* Overs placement in some patients does not allow adequate implant support due to thin breast tissue and skin.

* Inframammary incisions can stretch and cause the degeneration of the natural breast fold, allowing the implant to descend.

* Heavy implants will accelerate normal and expected breast tissue and skin ptosis in many patients, especially in Overs placements.

* Poorly executed implant placement during surgery. This is commonly a symptom of an inexperienced doctor.


Surgical revision is indicated for severe cases of bottomed out implants. The procedure varies, but usually includes the removal of the implants and the revision of the pockets. Internal sutures and tissue folding are typically performed to support the implant weight and the inframammary fold might need to be anatomically corrected. Changing implant placement to a patial under (good) or full under (better) placement will help considerably. Once the infrastructure of the breast is reinforced and any external issues addressed, the implants can be replaced in their new anatomical position.

There are pics here to see if yours are similar
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I would suggest seeking a 2nd opinion if your surgeon feels there isn't a problem, maybe with another company so you get an unbiased opinion then you can go back to your surgeon with this information.
It may just be that one is healing slightly faster than the other. But even if that is the case you may still want to bring up the fact that you are not happy with your PS as you said they do not have the fullness at the top that you requested

Ah thank you so much for your detailed reply. Mine look similar to the 2nd picture on the link you gave me but not as obvious as the other two. I'm 5 months po now and worried that it will only get worse.

I'll be glad tomorrow once I've seen the surgeon and know whether it'll be fixed or whether I'll have a fight on my hands

I'm thinking now that I wanna go under the muscle as I'm worried about it happening again.

Thank you again.x

Hiya

I had a change of implant on 1st Oct and an uplift. Mine look more like the second pic too and my ps says I have bottomed out. I am having an op on 1st April to correct it.
They also seem to slideto the side when i lie down

It is in both of mine really but worse in my left, he said both would have to be done even if one seemed ok to make them look even. He said it was a simple op and wouldnt take long, going as a day case.

Am seeing mine again on Monday, keep thinking he will change his mind and say they dont look that bad.

Keep us posted, good luck
Sharon x

Thanks Bumblebee. I have that 1st week in April off work so am hoping for a re-op around then. Just been reading on another forum that the 'fix' isn't 100% and you can bottom out again This is making me think I wanna change to unders but we'll see what he says tomorrow. I'll update you all then.x

Good luck hun

Look forward to hearing what your PS says as I have concerns re: my own.

Take care xx

Looking forward to finding out how you got on
Grace
xxx

Right guys, here goes with my update. Saw a ps today although not the one who performed my ba as he no longer visits Leeds. He was very confusing and contradictory in the things he was saying and I left feeling like I had no answers and that because I wasn't his patient he didn't want to know :-(

He said that he thinks I have a good asthetic result despite the fact that he has measured my left boob been nearly an inch lower than my right and empty looking at the top!!!!!! He said to fix it he would cut a half moon of skin out from under the crease and stitch it back together raising the breast higher but it wouldn't move the implant up to fill the top, it would only raise it so it didn't sit lower than the other.

I asked him about going under the muscle. He said if they did this it would leave a pocket above the mucle where my implants are now and they would look square for a year!! He said my elasticity of skin was fine and it wouldn't need that to fix the problem. I told him that I cannot sleep without my sports bra on and I have pain if I try to. He then said 'oh you have a problem with the elasticity then and will need to go under the muscle'. I said you just said I didn't need that and he said 'I don't know, I'm not your surgeon.'

He then went on to say I had asymetry of the breasts before hand which might be why it has dropped. I don not feel like I had asymetry of the breasts at all!!!! In my mind, every woman has slightly different boobs and can never have 2 exactly the same. I considered myself to be totally normal and my nipple may have been a millimeter different yet nothing to warrant 'asymetry'! I felt he was just trying to use that as a way out of a re op. I also said if that was the case why did my surgeon not take that into account when doing the surgery and use a different size implant or place it slightly higher to counter-act it??

He said he has to pass my details on to my surgeon who will decide what to do. I asked him if I was his patient would he do a re-op and he said he would cut the half moon and maybe do a pocket revision. I said so I'll get a re-op then and he said I can't say cos you're not my patient!!!

OMG just give me some answers!!!!!!! It's not fault my surgeon isn't here anymore (he's at their clinic in Marbella) so if you insist I see a different one for my check ups, surely I can insist on some answers from him!!!! Annoying!!!!!!!!!

So, they've left it that I have to travel to Newcastle to see him or I can see him the night before my proposed re-op date, which I'm not happy with. I don't fancy travelling to the Midlands not having a clue whats going happen, be told then get whisked straight in to be operated on. I've told them that I want them to reimburse me for travelling to Newcastle to see him. Why should I be out of pocket because he isn't available and the surgeons that are won't make a decision??

Sorry for the rant. I'm obviously a bit wound up after today!!

Aw hun so sorry he was evasive with you, I get the feeling he didn't want to tread on anyones toes or get in trouble with the clinic. I would speak about it with your surgeon as it looks like he will be the only one who will give you some answers. Good luck hun. I hope you get your answers soon.