Bottoming Out Breast Implants Sydney

Technical Explanation of the Condition

Bottoming out breast implants in Sydney refers to a complication where the implant drops too low on the chest because the lower breast pocket loses support. As a result, the breast may appear longer, the nipple can look too high on the breast mound, and the implant may feel heavy or unstable.

This issue can occur after breast augmentation, breast lift with implants, or breast reconstruction. In some patients, it develops gradually as the skin and soft tissues stretch over time. Alternatively, it can occur earlier when the pocket is unstable or when implant size, implant weight, or tissue strength do not match well.

A/Prof Tim Papadopoulos (FRACS) assesses bottoming out breast implants in Sydney with detailed examination and personalised surgical planning. During consultation, Dr Tim reviews your implant history, pocket anatomy, scar position, and tissue support. He then explains revision options, recovery, risks, and realistic outcomes as part of informed consent. Importantly, outcomes vary between individuals.

What Bottoming Out Breast Implants Can Look Like

Patients with bottoming out often notice visible changes in breast shape and implant position. For example, signs may include:

• implants sitting lower than expected

• nipples appearing too high on the breast mound

• a longer or “stretched” lower breast shape

• reduced cleavage symmetry or breast balance

• a lowered inframammary fold (breast crease)

• implant movement or a heavy sensation

• discomfort or bra fit issues (selected patients)

In addition, asymmetry may occur if one implant descends further than the other.

Why Bottoming Out Happens

Bottoming out occurs when the lower implant pocket loses structural support. Contributing factors may include:

• implant size that exceeds tissue support capacity

• thin or stretched skin and breast tissue

• weight changes or pregnancy following augmentation

• genetic skin laxity or weak connective tissue

• subglandular or subfascial pocket stretch (selected patients)

• inadequate support of the inframammary fold

• revision surgery history or prior pocket disruption

Because breast tissue strength varies between individuals, not all patients have the same risk profile.

Bottoming Out vs Other Implant Problems

Several implant-related conditions can appear similar. For this reason, accurate diagnosis matters.

Bottoming out vs implant malposition
Bottoming out is a type of malposition involving downward implant descent and weakening of lower fold support.

Bottoming out vs “double bubble”
Double bubble deformity occurs when the original fold remains visible above the new implant fold, creating a second crease line. In some cases, this can occur alongside bottoming out.

Bottoming out vs capsular contracture
Capsular contracture often causes tightness, firmness, distortion, or elevation of the implant. By contrast, bottoming out typically causes implant descent and stretching of the lower breast.

Therefore, Dr Tim confirms the diagnosis during consultation before recommending revision strategies.

Treatment Options for Bottoming Out Breast Implants

Treatment depends on implant position, capsule characteristics, and tissue quality. Therefore, management is always individualised.

In most cases, non-surgical options cannot correct established bottoming out. Instead, surgery is typically required to restore structural support and improve implant position.

Surgical Treatment: Bottoming Out Breast Implant Revision Surgery

Revision surgery aims to restore fold support, improve implant position, and optimise breast shape.

Dr Tim may recommend one or more of the following options:

Pocket repair (capsulorrhaphy)

Capsulorrhaphy involves internal repair of the implant pocket to prevent the implant from sitting too low. Dr Tim may use sutures to:

• tighten the lower implant pocket

• recreate the inframammary fold

• stabilise implant position

This technique remains one of the most common methods for bottoming out correction.

Implant exchange (selected patients)

Some patients benefit from changing the implant to a more suitable size, profile, or weight. For example, reducing implant size may:

• decrease strain on lower pole tissues

• improve long-term stability

Pocket change (selected patients)

If pocket design contributes to instability, Dr Tim may recommend changing implant plane, such as:

• subglandular → subfascial or submuscular (selected patients)

• submuscular → subfascial (selected patients)

Internal bra / mesh support (selected patients)

When tissue support is weak, Dr Tim may discuss internal reinforcement techniques to improve stability and reduce recurrence risk. However, suitability depends on anatomy and surgical factors.

Breast lift (mastopexy) (selected patients)

If skin laxity contributes to a stretched appearance, revision surgery may include mastopexy. This reshapes the breast skin envelope and can improve nipple position.

Recovery and Important Considerations

Recovery depends on the extent of surgery. However, most patients can expect:

• swelling and tightness early in recovery

• restrictions on heavy lifting and chest exercise initially

• supportive garments as advised

• a staged return to full activity

• follow-up visits to monitor healing and implant stability

Because correction often involves internal pocket repair, patients should follow post-operative instructions carefully to reduce recurrence risk.

Suitability for Bottoming Out Correction Surgery in Sydney

Patients may be suitable for correction if they:

• have a visibly low implant position

• notice nipple-to-breast imbalance

• experience discomfort, asymmetry, or dissatisfaction

• have stable general health

• accept scarring and recovery requirements

• do not smoke (or can stop prior to surgery)

Suitability for bottoming out breast implant revision in Sydney is confirmed during consultation.

Disclaimer:
All surgical procedures carry inherent risks. The information provided here is general in nature and should not be used as a substitute for an in-person consultation with a qualified specialist. Individual outcomes vary based on anatomy, healing, and adherence to post-operative care. A/Prof Tim Papadopoulos will discuss the potential risks, benefits, and realistic expectations during your consultation.

Safety, training and professional standards

A/Prof Tim Papadopoulos is a Specialist Plastic Surgeon (FRACS) and is registered with the Australian Health Practitioner Regulation Agency (AHPRA). He is also a member and Past President of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS).

Patients can also consult the Royal Australasian College of Surgeons (RACS) for information on surgical training and standards.