Breast augmentation is designed to create balanced, natural-looking results, but in some cases, implants may shift from their intended position. One of the more common concerns is “bottoming out,” a type of implant malposition that affects breast shape and symmetry.
Understanding how surgeons correct these issues can help patients feel more confident about their options. Board certified plastic surgeon Dr. Eugene Kim provides breast revision to patients in Beverly Hills, Los Angeles, Santa Monica, West Hollywood, CA, and surrounding communities.
What Is Bottoming Out?
Bottoming out occurs when the implant drops too low on the chest, causing:
- The nipple to appear too high on the breast
- Excess fullness in the lower portion of the breast
- A stretched or elongated appearance
This can affect one or both breasts and may develop over time.
What Causes Implant Malposition?
Several factors can contribute to bottoming out and other positioning issues:
- Weak or thin breast tissue
- Over-dissection of the implant pocket during surgery
- Large or heavy implants
- Gravity and natural aging
- Significant weight fluctuations
Other Types of Implant Malposition
In addition to bottoming out, implants may also:
- Sit too high on the chest
- Shift toward the armpit (lateral displacement)
- Move toward the center (symmastia)
Each type requires a different surgical approach.
How Surgeons Correct Bottoming Out
Correction involves restoring proper implant position and reinforcing the breast pocket.
1. Pocket Repair (Capsulorrhaphy)
The existing implant pocket is tightened to reposition the implant higher on the chest.
2. Internal Support Techniques
Sutures or reinforcement materials may be used to strengthen the lower breast tissue.
3. Implant Exchange
Switching to a smaller or lighter implant may reduce strain on the tissue.
4. Breast Lift
In cases of significant sagging, a lift may be performed to reposition the breast tissue and nipple.
How Other Malpositions Are Corrected
- High implants: The pocket may be lowered or released
- Lateral displacement: The pocket is tightened toward the outer breast
- Symmastia: The pocket is reconstructed to restore separation
Preventing Recurrence
Successful correction depends on addressing the underlying cause. Surgeons focus on:
- Proper implant sizing
- Strong pocket support
- Careful surgical technique
Bottoming out and implant malposition can affect both appearance and confidence, but they are correctable with the right surgical approach. A customized revision plan can restore balance, symmetry, and natural-looking results.
Contact the Office of Beverly Hills Plastic Surgeon Dr. Eugene Kim
Click here see more plastic surgery procedures and treatments performed by Board Certified Plastic Surgeon, Dr. Eugene Kim on patients in Beverly Hills, Los Angeles, West Hollywood, Santa Monica, CA and surrounding areas or call 310-271-6996 to schedule a consultation.