Bottoming out -- why???

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marketingmama
marketingmama Member Posts: 161
edited May 2018 in Breast Reconstruction

Ladies, I've had my fair share of post-BMX implant surgeries to date. Well last month I was told that I have fully bottomed out on one side (prior to this I was incapsulated!) and partially on the other. My PS is honestly scratching his head but said we'll do the standard of care (capsulography with Alloderm etc) in May. He also said that losing the muscle/support during BMX can cause this problem. I also asked if we should go down slightly in size as thought maybe the implant was too heavy. He said we could but also said lots and lots of women have implants of 600CC and are fine. Anyway, I'm soooo frustrated and don't understand what is wrong with me that things keep going wrong. I honestly don't believe it's my surgeon. He's wonderful and has a terrific reputation in my area. Leads our PS division. I'm sure there are always better surgeons but my stuff is not highly complex---just seems that something keeps going wrong every 4-6 months.

Thoughts on what causes bottoming out.

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  • Char66
    Char66 Member Posts: 65
    edited April 2017

    I am waiting with you to see if anyone else has had this happen. I too have bottomed out X2, always on left side. Had BMX Jan 2014, round silicone that bottomed out, now have teardrops that have done the same. Total of eight surgeries dealing with necrosis. Have constant discomfort in this area everyday. Really tired of dealing with it. What to do? Thanks for sharing.

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  • ravzari
    ravzari Member Posts: 277
    edited April 2017

    Bottoming out can be caused by a variety of things, which I found out while researching whether or not I wanted recon.

    Some things that increase the risk of the implant falling too low and bottoming out:

    - Being very thin.

    - Having little (or no) breast tissue.

    - Thin skin.

    - Implants placed above the muscle are at higher risk for bottoming out than implants placed sub muscular.

    - Implants that are too heavy/large for the person's frame (the weight can drag them down and out of the pocket).

    - Over dissection of the pocket.

    When bottoming out occurs within a few weeks of surgery it's USUALLY over dissection. When it occurs later on, it's typically due to the weight of the implant(s) combined with some of the other issues I mentioned above.

    Aside from over dissection, it's not normally the fault of the surgeon or anything the surgeon did wrong, it's, unfortunately, just how that individual's body is reacting to the implants.

    600cc is pretty large, so it may be the size & weight of your implants that keeps causing the issue here.

    Your PS is right that lots of women have 600cc implants with no problems, but "lots of women" does not equal "all women" and a lot of those "lots of women" are likely standard breast augmentation patients and not reconstruction after mastectomy (so, no breast tissue at all) patients and those two types of patients are very, very different in terms of what's required to get a successful result.
    If you keep bottoming out with 600cc implants, it may not be a bad idea to downsize and see if that stops it from happening again.

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  • marketingmama
    marketingmama Member Posts: 161
    edited April 2017

    Thank you! I do plan to downsize and will select on Friday. Surgery is May 11 -- ADM, bilateral capsulograhy including suturing to ribs (ouch!).

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  • Latiscar
    Latiscar Member Posts: 1
    edited May 2018

    Hello Marketingmama!


    I had implant exchange on October 13, 2015 and quickly bottomed out. I had a repair for the bottoming out on April 12, 2016, and that repair has shifted rather quickly, within 2 months of surgery. My implants are 400cc.


    I have been reading a great deal on what causes bottoming out and I have spoken with my surgeon about next steps.


    I thought we could just touch base and connect.

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