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Correction for Bottoming Out

Most women enjoy the results of their breast augmentation, but a small number of breast augmentation patients may experience bothersome complications. Bottoming out occurs when one or both breast implants slips below the inframammary line, resulting in what many patients consider an unsatisfactory breast appearance.

Identifying Bottoming Out

  • Implants that sit below the inframammary line
  • Nipples that point upward
  • Decreased fullness in the upper poles of the breasts
  • Breasts that seem bottom heavy

Causes of Bottoming Out


  • Implants that are too large or heavy can weaken breast tissue, compromising the implant pocket.
  • Sometimes bottoming out can occur when there is not enough breast tissue and skin to hold a larger implant.
  • Loss of skin elasticity can influence the body's ability to support an implant, especially a large implant.

Weak Breast Tissue

  • Bottoming out can occur in women who have mild sagging that is not treated with a breast lift at the time of breast augmentation.
  • Pregnancy and weight fluctuations can also compromise breast tissue strength.
  • Poor skin elasticity and loss of support of the tissues along the breast fold can also contribute to bottoming out.

Implant Placement

  • The over dissection of the implant pocket can cause improper implant placement, which may lead to bottoming out.

Breast Revision to Correct Bottoming Out

When breast implants shift and become malpositioned, the best method of correction is breast revision surgery. It is common for a synthetic mesh scaffold to be placed within the breast to support the compromised tissue. Sometimes the implants are exchanged during breast revision to alleviate the stress on weakened breast tissue and to produce an improved aesthetic. Postoperatively supporting the fold with an underwire bra may prevent recurrence.

What to Expect During Recovery

Schedule a Consultation With Dr. Koch

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Frequently Asked Questions

A: It is best to wait at least six months before undergoing breast revision because it takes about that long to see your final breast augmentation results. If you notice any complications after your primary breast surgery, consult with your plastic surgeon immediately.

A: Not all bottoming out occurs because of having implants that are too large, so it is not always necessary to exchange them for smaller implants. However, if that is the cause of bottoming out in a given patient, it is highly recommended to downsize for implants that can be adequately supported.

A: Yes. Since bottoming out may be caused by poorly placed implants, they are often repositioned to form a more pleasing breast profile.

A: As long as you are satisfied with the results of your revision surgery, your results should be long lasting. Future complications or natural wear to your implants may require additional correction in about 10 to 15 years.