Bottoming out is a condition in which a breast implant slips below the crease of the natural line under the breast and the nipple appears higher than where the implant landed. This condition is very prevalent in women who are very thin and have essentially very little breast tissue. Bottoming out also occurs when an implant is placed over the pectoralis muscle.

How does it happen to hit rock bottom?

During breast augmentation, bottoming out occurs when the implant pocket is dissected too far. It can also occur when the inframammary fold is too low during the first operation.

Also these errors are seen more in inexperienced surgeons. Veteran surgeons have been known to make a different kind of mistake by inserting an oversized implant that causes skin stretching. Eventually, a pocket forms under the implant creating a space for the implant to slide into.

Most bottoming cases are reported within a few months; however, if it forms years later, it may be due to an implant that is too heavy. It is most common in breast implants that were inserted through axillary, inframammary, and periareolar incisions.

Is it specific to a type of breast implant?

You can bottom out with any type of implant, be it saline or gel, textured or smooth, and round or tear drop.

Can it be corrected?

Fortunately, bottoming out is a condition that can be easily corrected with the help of an experienced, board-certified surgeon. You can check whether or not your plastic surgeon is certified by doing a quick query through the Australian Society of Plastic Surgeons database.

Below are different procedures used to correct the background:

1. Implant replacement. This procedure involves closing the pocket and replacing the old implant with a new one.

2. Capsulorrhaphy. This involves placing sutures in the lower half of the breast. Next, the capsule that holds the implant is adjusted while adjusting the position and size of the implant. This will make it sit higher on your chest.

3. Breast lift. This is a form of plastic surgery whereby the patient’s breast is lifted to give it a more youthful appearance. In this case, if a patient’s breast has bottomed out and her skin has lost its elasticity, a breast lift will help correct the condition.

Corrective surgery to bottom out usually lasts between one and three hours. The length of the procedure will depend on the amount of reconstructive work that needs to be done. Patients can recover in four to six weeks and can resume normal activities one week after surgery. However, it is recommended that the patient avoid strenuous activity for at least 10 days and wear a reconstructive bra for up to six weeks.

Hitting rock bottom should not be a cause for alarm for patients who are experiencing it. Simply contact your surgeon and arrange for reconstructive surgery to be performed. You may prefer to find a more experienced surgeon rather than the surgeon who performed the initial operation.