Bottoming Out Correction in Raleigh, North Carolina*

Bottoming out is a condition related to breast implant surgery where the support of the lower fold of the breast is insufficient to maintain a breast implant in proper position. This condition is usually noted with women with loose tissues and can happen even in the best of hands. Avoidance of this problem during surgery can be done with a few surgical maneuvers however it sometimes is unavoidable. This patient underwent an implant mastopexy procedure by another physician 3 years ago. She had placement of silicone gel implants in the sub muscular position and mastopexy. She had an issue postoperatively with lowering of the breast folds and the original surgeon attempted to correct this with suture technique. When this failed a mesh support was added but this never worked. She went to another physician who made 3 separate attempts at repair of her right inframammary fold. Despite these attempts she had persistent asymmetry. She sought Dr. Lyle's opinion and he felt the support to the chest wall had to be reinforced. The patient also had a downsizing of her implant at one time and wished to go back up in size which would be even more challenging. During surgery, Dr. Lyle noted loosening of the previous mesh support so it was repositioned utilizing drill holes into her rib. An additional piece of Galaflex mesh was utilized to reinforce the repair. She was upsized from 275 cc up to 3 30 cc. The correction held . After six prior attempts-success!