Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. It is the loss of internal implant support where implant placement with partial, or no, muscle coverage, allows slow downward migration of the implants. This is because support of the implant by the skin alone is not always enough to prevent downward migration of the implants. Also, over-dissection of implant pockets at the time of surgery may cause immediate bottoming out. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.

The Surgical Procedure

The operation time varies depending on what exactly would need to be performed. We will review this with you after you have been examined by Dr. Pousti.

For correction of bottoming out, the procedure can take from 1-3 hours depending on how much work is involved. Board Certified Plastic Surgeon, Dr. Pousti takes his time in the operating room to make sure that he does what he can to achieve the patient's results. Usually an internal suturing technique is used to correct the pocket and therefore the implant placement on the chest.

What To Expect After Surgery

Pain is rarely strong, more commonly being a degree of discomfort. Swelling occurs but usually begins to subside by the third or fourth day. Some degree of swelling may persist for longer periods. A well-fitted bra is worn day and night for three weeks. While there is probably seldom interference with future breast feeding, women are cautioned that it may not be possible to breast feed in the future.

The surgical bra is used to stabilize the area after the repairs are made.

Resumption Of Physical Activities

Driving may be resumed in 1-2 weeks.
Non-contact sports in 3 weeks.
Contact sports in 6 weeks.

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