Breast

"Bottoming out" refers to a condition where a breast implant settles too low on the chest, causing the nipple to appear excessively high on the breast mound.² This occurs when the implants descend below the natural crease of the breast, leading to an unnatural appearance and potential discomfort. Factors contributing to bottoming out include improper implant size or placement, inadequate tissue support, and surgical techniques. Correction typically involves a surgical intervention to reposition the implants higher on the chest wall and reinforce the lower breast fold. Addressing bottoming out restores proper implant positioning, enhancing both the aesthetic outcome and patient satisfaction.

Capsular contracture is a common complication associated with breast augmentation, characterized by the formation of scar tissue (capsule) around the implant that becomes thickened and tight.³ This condition can lead to various symptoms, including breast firmness, pain, and distortion of the breast shape. Treatment options range from non-surgical interventions like massage and medication to surgical procedures such as capsulectomy (removal of the scar tissue) or implant exchange.

Double bubble deformity is a condition that can occur after breast augmentation surgery, characterized by the appearance of two distinct breast contours, resembling a double fold or bubble beneath the breast. This deformity typically arises when the natural breast tissue descends below the implant, creating a noticeable crease or indentation. It can result from various factors such as improper implant size, placement, or inadequate tissue support. Surgical correction may involve adjusting implant position, resizing, or performing a mastopexy (breast lift) to address the underlying issues.

This condition can occur following breast augmentation surgery when teardrop-shaped implants are not properly positioned within the breast pocket. This misplacement can result in asymmetry, unnatural breast contours, or visible implant edges, affecting the overall aesthetic outcome. Surgical correction involves repositioning the implants, either by adjusting the pocket or exchanging implants for a better fit.

This encompasses a range of concerns regarding the placement and symmetry of the implants within the breast pocket. These issues can include implant displacement, where the implants shift from their intended position, leading to asymmetry or unnatural breast contours. Addressing these concerns often requires implant repositioning, exchange, or revision, to achieve optimal aesthetic outcomes and restore symmetry.

A ruptured implant occurs when the implant's outer shell develops a tear or hole, causing the silicone or saline filling to leak into the surrounding tissue. This may lead to a change in breast shape or size, discomfort, or asymmetry. While silicone implant ruptures are often silent and may only be detected through imaging tests like MRI, saline implant ruptures typically result in noticeable deflation of the breast. Treatment typically involves surgical removal and replacement of the ruptured implant.

With this complication, patients may see the edges of the implant through their breast tissue, which leads to a rippling effect on the outside of the breast. This tends to be most common with saline implants placed above the chest muscle. A correction may involve repositioning the current implants or replacing them with implants that are a better fit for the patient’s body.

Patients may seek size changes to achieve their desired breast appearance or address changes in body proportions over time. Whether opting for larger or smaller implants, it's essential to consider factors such as body frame, lifestyle, and aesthetic goals when making size adjustments. Size changes may involve surgical procedures such as implant exchange or revision to accommodate the desired size or address issues like implant malposition or rippling.