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Bottoming out

Most women who undergo breast augmentation are very happy with their breast implants. However, a small number of women are troubled by implants bottoming out due to tissue stretching and relaxation, and large implants. We will discuss this problem and how to fix it in this article.

After breast implants are placed, the skin, muscle, and deeper tissue stretches to accommodate the implant. It usually feels pretty tight for the first several weeks or months while your body is adjusting to the new implant. Once the tissue relaxes, the tightness improves, and the implants look better and more natural. Your breast tissue will often relax more one side, resulting in shifting of the implant. In rare instances, the shifting of the implant and the resulting asymmetry can be more dramatic, and you may desire breast revision to correct this.

Implant position is determined by the implant pocket. Hence, pocket adjustment is essential to reposition the implant and gain better symmetry. When there is relaxation of the inframammary fold (breast crease), the implant can slip below the crease, this is called “bottoming out” and the deformity is referred to as a “double bubble.” Internal sutures can be placed to reinforce the inframammary crease and give support to the implant, and reposition it higher on the chest wall. In some situations, it may also be necessary to have some temporary sutures on the outside.

When the lateral (side) tissue relaxes too much, then the implants may look good while standing up, but they fall to the sides when you lie down. In this situation, internal sutures are placed to tighten the lateral sides of the pockets, to shift the implant more medially, and bring them back onto the chest.

Call for a consultation today, as Dr. Dass, in Los Angeles, is experienced at revising breast implants.


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