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Bottoming Out and Breast Implants

WHAT IS BOTTOMING OUT?

Bottoming out is a recognised term in the postoperative breast recovery domain. It is a natural and anticipated process for breast implants to experience a slight drop after surgery, commonly referred to as “The Drop and Fluff.” However, if an imbalance occurs, the implants may bottom out, leading to an excessive drop beyond the expected range. As a result, the area below the nipple can appear disproportionately elongated, while the nipple may be positioned too high on the breast, causing it to point upwards. 

WHAT CAUSES BOTTOMING OUT?

  • Poor skin quality
  • Large volume implants
  • You needed a breast lift (mastopexy) but only got breast implants
  • The breast pocket dissected for the implant has been made too large or the breast implants were not placed in the correct position
  • Overuse of the pectoral muscles too early in your recovery
  • Not following your post-operative instructions and post-operative bra

After you have implants inserted, it takes approximately 3 months for the capsule to form around the foreign object. This capsule will help hold your implants in place. Until this capsule is formed, the only thing providing support to your breasts is your bra. This is particularly important when doing activities that involve your pectoral muscles (lifting your arms, pushing, pulling, etc). The pectoral muscles will contract and push on the implant. If there is no capsule or bra in place for support, there is only one direction for the implant to go…downwards. 

HOW TO CORRECT BOTTOMING OUT?

Correction of bottoming out usually requires additional surgery; implants are removed, and the pockets may be tightened. Sometimes an internal bra or mesh is fitted. A breast lift may need to be performed in conjunction to remove excess skin and reposition the nipple.

BOTTOMING OUT VS THE DROP & FLUFF

It is expected most breast implants will settle into their position within the breast pocket, you may recognise this term as drop and fluff”. This process can take 3 – 6 months. After surgery, you will be swollen, and your breasts may initially look larger (particularly in the upper pole) and more projected. Once this swelling subsides and the fullness in the lower pole rounds some patients mistake this for bottoming out.

 

Bottoming Out

Bottoming Out

 

Bottoming Out

 

Bottoming Out

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