Correcting Improper positioning of chest Implants

Dr. Revis uses his innovative internal Bra technique for mediate of bottoming out, twin bubble and also synmastia (also well-known as symmastia).

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What is bottoming out?

Bottoming the end is a particular example of a post-operative difficulty requiring a thorough, methodical approach and innovative surgical techniques. Dr. Revis has seen a dramatic increase in the number of patients presenting from other offices and other countries with bottoming the end of one or both implants. Currently, this is the most typical revision the performs, usually 2 to 3 times a week.


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After right Breast Repair After Left breast Repair
Intraoperative photos show a fix of serious bottoming out and lateral displacement the both breasts using the inner Bra procedure. The incisions along the reduced areolar boundaries will be closed and will cure inconspicuously.

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Before After
Photos display a 32 year old the end of state patient v bottoming out and also a large gap, in ~ pre-op and also six weeks post-op. An interior Bra procedure to be performed, together with an implant exchange from 275cc moderate plus profile silicone gelatin to 325cc middle plus file silicone gel.

Bottoming out is existing when one or both implants are positioned too low or also lateral on the chest wall surface in relationship to the nipple position. This means that the pocket, or capsule, surrounding the implant has become too short on the chest wall or rests too much laterally as soon as lying down.


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Bottoming Out: example 1 Bottoming Out: instance 2

This might represent overdissection of the pocket in the an ar of the inframammary crease throughout surgery, cut of the lower part of the pectoralis muscle, or may take place naturally end time and under the effects of gravity in patients through implants that space placed over the muscle or only subpectorally (partially submuscular) when compared to full submuscular location of chest implants.


What is double bubble?

double bubble (shown below) is current when there is a groove follow me the breast below the nipple giving the figure of the breast sitting on top of the implant. This is sometimes observed in patients with bottoming out. The groove to represent the old inframammary wrinkle that has actually lifted off of the chest wall and permitted the implant come slip out from underneath the breast.


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Double Bubble: example 1 Double Bubble: instance 2

What space the symptoms of bottoming out?

Most patient report that they have actually a hanging or hefty sensation since of lack of support for the implant. This may additionally be add by a mild uncomfortable or a genuine pain. Rippling might be present also because of the thinned tissues follow me the bottom that the breast.

How is bottoming out diagnosed?

Bottoming the end is usually diagnosed through the patient or by a plastic surgeon. An knowledgeable plastic operated doctor should be able to diagnose bottoming the end from picture alone.

When diagnosing yourself, in addition to the hefty or uncomfortable feeling, you may also an alert a worsening of your implant place in relation to her nipple position. This may cause the appearance to it is in unattractive and even uncomfortable once wearing no bra. Since the implants hang as well low, you might not be comfortable going braless. You might need to wear a pushup bra come correctly position your implants or to save them from falling much apart and even right into your armpits once lying down.

Proper implant position means that the nipple is focused on the center of the chest implant. If an ext of the implant rests below the nipple than over the nipple, climate you have bottoming out.

Can bottoming the end be repair non-surgically?

unfortunately in Dr. Revis" experience, he has discovered that the inner Bra procedure is forced to exactly bottoming out. Bottoming out is a progressive disorder that normally gets worse gradually as the impacts of gravity reason the implant come sag within the organization envelope of the breast. The heavy or uncomfortable feeling usually likewise worsens with development of the bottoming out.

Will convert to smaller implants exactly bottoming out?

Switching to smaller sized implants alone will certainly not exactly bottoming out. The new implants will certainly still sink come the bottom the the pocket, acquisition even much more volume far from the upper pole fullness. In my experience the just true, long term correction for bottoming out is an internal Bra procedure.

How deserve to bottoming the end be corrected?

To correct bottoming out, Dr. Revis performs the inner Bra procedure. Using unique lighted retractors, Dr. Revis increases the implant pockets (capsulotomy) superiorly and also medially, producing room because that the implants to be repositioned in ~ a higher level, creating better cleavage, a much more youthful shape, and also improved fullness in the upper pole the the breast.

Dr. Revis then closes component of the pocket the rests laterally and inferiorly, thus preventing the implants from resting too low or falling too laterally come the sides. Dr. Revis offers permanent sutures for a long-lasting result. This sutures are closely placed so the the suture product is never in direct call with the implants within the body.


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Before After
Photos show a 26 year old international patient with bottoming out and also rippling, in ~ pre-op and twelve main post-op. An interior Bra procedure was performed and also Strattice placed bilaterally, in enhancement to one implant exchange indigenous 700cc high file silicone gel to 800cc ultra high file silicone gel.

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How long will the interior Bra last?

With Dr. Revis" technique, he has found that after ~ the internal Bra is completely healed (around 12 weeks), it normally lasts because that many, numerous years. This truly anatomical correction places the tissues earlier in their suitable orientation, the method the body was designed. The patient below is one example of wonderful long term result.


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Before After
Photos present a 28 year old patient with bottoming out, in ~ pre-op and also 9 year post-op, v no change of implant size, demonstrating the terrific long term support provided by the interior Bra procedure.

May i switch to bigger implants as soon as I have my bottoming out corrected?

Absolutely. Approximately 40% of patients that undergo the interior Bra procedure store the same size implants, 40% boost the dimension of their implants, and the staying 20% reduce the size of their implants. The size/weight of the implants has no connection to the success or the long-lasting nature of the bottoming out correction v the inner Bra technique when that is performed properly with irreversible sutures.

What is synmastia?

Synmastia (shown below) is present when one or both implants space positioned also close to the midline end the breastbone (sternum). This way that the pockets, or capsules, neighboring the implants room too medially placed. Please view Synmastia / Symmastia for much more informationon this complicated issue.

May ns see instances of the interior Bra procedure?

you re welcome click the links below to evaluation pre- and also post-operative image of the interior Bra procedure, as well as numerous examples of other breast implant problems.

Internal Bra Procedure before & ~ Photos breast Augmentation Revision prior to & after Photos

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