Bottoming out occurs when the implant settles too far down on the chest wall, below where it should sit. The lower pole stretches, the implant sits low, and the nipple can appear to point upward.
Causes
- An over-released or over-dissected lower pocket.
- Large or heavy implants stretching weak or thin tissue over time.
- Poor lower-pole tissue support.
Prevention and treatment
Choosing an appropriate implant size for your tissue and precise pocket creation help prevent it. Lightweight implants may reduce long-term load in some cases. Correction usually involves surgically reinforcing the lower pole (internal sutures or support material) and sometimes a smaller implant. It is a recognised reason for revision.