Bottomed Out Breast Implants
Breast implant bottoming out repair is not simple.
When the inframammary fold is released too much, the breast implants can drop down too low.
This is known as bottoming out.
It doesn’t look good and the malposition of the breast implants can get worse over time.
Patients tend to say that the implants looked very good initially, but then, changed over time.
In some cases, the patients say that the implants looked perfect on the initial post-operative visit.
That is a bad sign because typically, breast implants will ride high in the first few weeks postoperatively because of swelling and sometimes because of submuscular placement.
Thus, the implants should need to drop.
If they are in perfect position right away, they can be a problem.
Breast implants bottoming out repair
Breast implant bottoming out repair should be customized to each patient.
The patient’s problems and anatomy needs to be analyzed carefully.
The proper approach to repairing the problem should be the safest and most effective technique.
Many factors contribute to the evaluation of the patient including the implant size, position of placement (sub muscular, sub fascial or sub glandular), the degree of bottoming out, the quality of the breast tissue, and skin thickness.
Anatomic factors are important, such as chest wall shape and width.
The repair can include sutures, mesh, acellular dermal matrix, transcutaneous sutures, and fat grafting.
Each patient needs a custom approach.
In general, a support procedure that is at least two rows of sutures if not three is necessary to reconstruct the inframammary fold.
Whether or not a mesh is used or some type of acellular matrix depends on the degree of bottoming out and the quality of tissue.
Of course using multiple modalities is frequent in these cases.
It’s sort of belt and suspenders kind of approach.
For more information about breast implant bottoming out repair, feel free to contract the office of Dr. Jay Calvert at +1.310.777.8800 in Beverly Hills, +1.949.644.2858 in Newport Beach, and +971.4.429.8533 in Dubai.