Bottoming Out and Downsizing of the Breast
Many women present to me who have had breast implant surgery several years ago throughout the United States. As many women age, they desire to downsize their breast implants in order to reduce the heaviness of their breasts as well as at times with bottoming out that may incur, they also desire to tighten up the inframammary fold at the same time. The below example is an example of a patient who presented from out-of-state with enormously disproportionate breasts. She is only 26 years of age; however, even at her age she believes the implants a way too large for her body. She desired to have those removed and replaced with smaller silicone gel implants and an internal capsulorraphy and inframammary tightening procedure was performed to recentralize the nipple areolar complex to the middle of her breasts. The preoperative photos show disproportionately large breast implants which the patient felt were too large for her body and also causing back pain. The implants were so large that they were leading to bottoming out as well as where there was inferior displacement of the implants with the nipple now migrating superiorly towards the top of her breast mound.
The patient underwent, through inframammary incision only, open capsulotomy, removal and replacement with smaller silicone gel implant by 225 cc reduction in size of implants, and subsequently an inframammary tightening procedure through the inframammary mastopexy well hidden along the inframammary fold. The patient has done well and this is her three-month postoperative photos. This is an example of bottoming out that can be corrected by an inframammary skin lift with a small internal capsulorraphy along the inframammary fold and a downsizing with significantly smaller implants.