Breast implants can drop too much. This is referred to as “bottoming-out” and usually gives the appearance of breast sagging. The difference between true breast sagging or ptosis versus bottoming-out, is that nipple position is usually preserved in the bottomed out implant where as in the sagging breast the nipple position is low. The reason why implants bottom out is because of gradual thinning of the supporting tissue of the lower breast. The weight of the implant stretches the skin and tissue between the nipple and the lower breast fold. The bottomed out breast appears to have a large amount of skin between the nipple and fold, which gives the sagging appearance. This can be associated with rippling on the side of the breast secondary to thinning of the breast tissue.
Bottoming out of the breast can be corrected by removing lower breast skin and adding an internal supporting sling made of collagen. Breast implants can be maintained or changed in size or to silicone breast implants or saline breast implants. Correction of the breast does add longer scars in the fold of the breast, but these fade over time and the body does grow into the collagen internal sling. The operation is an outpatient operation and is a very easy recovery. Secondary cosmetic breast surgery will help correct the negative effects of breast augmentation and help to improve the shape and feel of the enhanced breast.