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Plastic Surgeon DirectoryBreast Augmentation and Breast Implant Plastic Surgery Mega-Site
Breast Surgery -> Breast Implant Reconstruction

Breast Implant Reconstruction Surgery
Breast Augmentation PhotosBefore and After Photos, FAQ & Information

Symmastia - Bottoming Out - Tuberous Breasts - Lateral Displacement - Inverted Nipple

Breast Reconstruction Options - Breast Recontruction Resources

Breast Augmentation ~ Pocket Correction  

Implant mal-position occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (“riding high”), inferiorly (“bottoming out”), medially (“symmastia or uni-boob”) or laterally (falling outward into the axilla).

Breast Redo after Implant Bottoming Out

Bottoming out involves inferior migration of the implants. This causes the nipple areola complex to appear too high on the breasts.  Also, the distance from the areola to the inframammary fold is too great. This is corrected by “raising” the inframammary fold using internal sutures. This is done after careful measurements are made from the areola to the “new” inframammary fold.

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 This 25 year old patient from Palm Desert, California had her first breast augmentation surgery performed in Mexico. A few months after getting her breast implants, she noticed that she had developed symmastia (the implants were touching down the mid-line) and her implants were bottoming out. She had a uni-boob (as some call it). The patient was extremely upset about the results and worried about having revisionary surgery. She found Dr. Pousti through her sister who had surgery and was very pleased with her results. She had bottoming out of both breast implants, encapsulation of both sides (left > right), and the areola were displaced laterally on both sides. This patient is ONLY 3 months out of surgery so there is still some bruising and swelling but we can see what an amazing result she achieved. This patient chose to have silicone gel implants (575cc on the left and 533cc on the right). She is VERY HAPPY with her results. 
This 22 year old patient was not happy with the shape of her breasts after her first breast augmentation.  The implants had bottomed out. She traveled from Boston, Massachusetts to have Dr. Pousti take care of her breast augmentation revision. She is very happy with her results. She has a 390cc saline implant on the left and a 370cc saline implant on the right.
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This 23-year-old patient from Corona California had her first breast augmentation in 2005. She noticed her breast implants "bottoming out" and came to meet Dr. Pousti regarding corrective surgery of her breast implants in 2007. Dr. Pousti performed revisionary surgery with removal and replacement of both breast implants in May of 2007 with 390cc saline implants. Dr. Pousti fixed the position of the pocket so that the breast implants have a natural look to them.  She is 1-month post op revisionary breast augmentation surgery and she loves her results. 

Breast Augmentation PhotosMore Bottoming-Out Photos

Repair of Bottoming Out - by Dr. Michael Ciaravino, Houston & Sugarland, TX

Bottoming-Out Photos - by Dr. Frederic H. Corbin, Beverly Hills, CA

Bottoming-Out Photos - by Dr. Thomas M. DeWire, Richmond, VA

Bottoming-Out Photos - by Dr. Don Revis, Fort Lauderdale, FL

Bottoming-Out Photos - by Dr. Steven Teitelbaum, Santa Monica, CA

Bottoming-OutBreast Augmentation FAQ

Bottoming-Out FAQ - by Dr. Thomas M. DeWire, Richmond, VA

Bottoming-Out FAQ - by Dr. Don Revis, Fort Lauderdale, FL

 

Specialists in Bottoming-Out Repair
Other plastic surgeons may be able to correct your implants, please check our surgeon directory here.

California - Florida - Texas - Virginia

California Plastic Surgeons

Breast Augmentation PhotosBottoming-Out Photos - by Dr. Frederic H. Corbin, Beverly Hills, CA
Breast Augmentation PhotosBottoming-Out Photos - by Dr. Steven Teitelbaum, Santa Monica, CA

Florida Plastic Surgeon

Breast Augmentation PhotosBottoming-Out Photos - by Dr. Don Revis, Fort Lauderdale, FL

Breast Augmentation FAQBottoming-Out FAQ - by Dr. Don Revis, Fort Lauderdale, FL

Texas Plastic Surgeon

Breast Augmentation PhotosRepair of Bottoming Out - by Dr. Michael Ciaravino, Houston & Sugarland, TX

Virginia Plastic Surgeon

Breast Augmentation PhotosBottoming-Out Photos - by Dr. Thomas M. DeWire, Richmond, VA

Breast Augmentation FAQBottoming-Out FAQ - by Dr. Thomas M. DeWire, Richmond, VA

Tuberous Breasts Repair & Photos

Some patients present to our office with a desire to increase the fullness of the inferior pole of the breasts. The distance from the areola to the “new inframammary fold” is increased using gentle dissection.  Use of an implant can help increase the fullness of the lower poles of the breasts. This is done routinely for patients with constricted or tuberous breasts. Tuberous Breasts have a very narrow base and usually a long skin envelope. Sometimes people refer to "Tuberous Breast" shape as the shape similar to "snoopy's nose". In the most severe cases of Tuberous Breast, a breast lift can be done through an incision around the areola, making the breast into a more rounded shape that the patient will be happy with. In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient.

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      This is a 18 year old patient from Murrietta California, interested in breast enlargement and found Temecula Plastic Surgeon Dr. Pousti over the internet. She was looking for a very large result. She also had some constriction of her breasts and wanted the shape to be more natural.  This patient is now 2 months post op breast augmentation with 800cc smooth round moderate profile saline implants made by the Inamed Corporation. She is very happy with her results.

 
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      This 24 year old patient from San Diego, California came in to meet with Dr. Pousti regarding her constricted breasts. She has tuberous (tubular) breasts deformity and wanted breast implants to correct it.  She is now about 2 months post-op correction of her tuberous breasts with 450 cc silicone gel implants made by the Mentor Corporation.  
 

      Lateral Displacement Reconstruction

Some post operative breast augmentation patients present with lateral (outwardly) displacement of the breast implants.  This can be corrected using an internal suture technique decreasing the size of the pockets and moving the implants toward the midline. 

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This 30 year old patient traveled from Arizona to have Dr. Pousti correct her “bottoming out” and the “lateral displacement” of her implants (left >right). Dr. Pousti performed “markings” on the patient the night prior to surgery to assist during the operation the next day.  

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In the operating room, you can see how the right side has been corrected and the left has not yet been corrected.  

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The patient is only a couple of weeks post-operative revisionary breast surgery but very happy with her results. 

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Breast Augmentation Reconstruction PhotosMore Breast Reconstruction Surgery Photos

Breast Reconstruction Surgery: Weighing the Options

Dr. FerraroIn an era - medical breakthroughs, it is reassuring to learn that breast cancers are being diagnosed in there earliest stages so that, according to the American Cancer Society (ACS), 96 percent - women with such cancers are alive after five years. Another promising trend: advances in reconstructive techniques have made it possible for plastic surgeons to create a breast that more resembles a natural one.

"One - the most frequent questions among women facing breast surgery is 'how will I look afterwards'?" said Dr. Frank J. Ferraro, an attending plastic surgeon at Pascack Valley Hospital in Westwood. "They worry about whether their clothes will fit and if they will still feel attractive."

In the past, the majority - women who had mastectomy surgery wore a prosthesis - a breast form made from materials that have the weight and feel - a natural breast - in their bras and bathing suits after surgery. Many women found such a prosthesis inconvenient or uncomfortable and wanted to feel "whole" again; plastic/reconstructive surgeons began to develop techniques to restore the shape and contour - the original breast. According to NIH, today about 75 percent - women who have mastectomies choose postsurgical reconstruction.

CHOICES IN BREAST RECONSTRUCTION

"Advances in breast reconstructive surgery mean that almost all women are candidates for the procedure," Dr. Ferraro observed. Cosmetic results also have improved. Although a reconstructed breast isn't a perfect copy - the original, many women - especially those with stage one tumors, the smallest - find that their breast may look almost unchanged.

If you are planning to have breast reconstruction surgery, you must find a plastic surgeon skilled in the procedure before the mastectomy surgery so that the plastic surgeon can work with the general surgeon to develop a plan that lends itself to reconstruction. Since this is a demanding technique, it is important to choose a plastic surgeon who is bored certified in this specialty and experienced in breast reconstruction.

Women can choose to have the procedure at the same time as the mastectomy operation or return to the hospital for reconstruction several weeks or months later. The women and her surgeons will discuss what type - procedure is best for her: an artificial implant or a muscle-flap procedure in which the breast is reconstructed with skin, muscle and fat taken from another part - her body. Factors to be considered include the woman's medical history, height, weight and amount - body fat as well as other medical conditions.

CHOOSING A MUSCLE FLAP

Although implants require less extensive surgery and shorter hospital stays, many women now choose muscle flap procedure. Dr. Ferraro, who learned the techniques at Duke University Medical Center in Durham, North Carolina, is a leader in the procedures. "Muscle-flap procedures use tissue from the back or abdomen to either form a breast or create a pocket for an implant. As a result, the breast looks more natural." The flap is made in several ways. In the latissimus dorsi technique, tissue is transferred from the area on the back below the shoulder blade way - tunnel made under the skin in the underarm area. The blood supply to the muscle is left intact. The muscle and skin create a pocket that an implant fills out to provide a breast shape.

The TRAM flap is another variation. The flap comes from the transverse rectus abdominus just below the waistline. The reconstructive surgeon detaches a small piece - skin, muscle and fat and pulls it through a tunnel under the skin between the abdomen and chest. Some women have enough extra fat in the abdomen to create a breast shape without an implant.

One advantage - the TRAM techniques is that some women find that their abdomens look flatter - as though they have had a tummy tuck. Women who have chronic lower back problems often choose other techniques since they may develop weakened abdominal muscle after the procedure and can increase back strain.

 A third technique, the free flap, eliminates the tunneling step. A portion - skin, fat and blood vessels is removed from the buttock, thigh or abdomen and move to the breast area. The blood vessels in the flap are sewed to the vessels under the arm at the mastectomy site. Because extensive microsurgery is required to reattach the blood vessels, the free flap is the most technically demanding - the muscle flap procedures. This technique, however, gives superb results.

"Women who smoke or have diabetes may be poor candidates for muscle flap procedures because their blood vessels may have narrowed enough to prevent healing - the flap," Dr. Ferraro noted. "That's why we advise patients to quit smoking and keep their blood sugar as close to normal as possible so that they can benefit from these procedures and have a natural looking breast."

Breast Augmentation Reconstruction Photos
Breast Reconstruction Surgery Photos

California - Florida - Illinois - Indiana
Maryland - Minnesota - Nevada - New Jersey
New York
- Ohio - Pennsylvania
South Carolina - Texas - Virginia - Wisconsin

 
 

Breast Augmentation Reconstruction Photos
Inverted Nippple Repair Photos

 

Inverted Nipple Repair - Dr. Rucker, WI & MN

Inverted Nipple Repair - Benedetti Cosmetic Surgery, St. Petersburg, FL

California Plastic Surgeons Breast Reconstruction Before & After Photos

Breast Reduction PhotosImplant Exchange Photos ~ Dr. Calvert, Beverly Hills & Newport Beach, California
Breast Reduction PhotosBreast Reconstruction Photos ~ Dr. Calvert, Beverly Hills & Newport Beach, California
Breast Augmentation Reconstruction Photos
Breast Reconstruction Photos ~ McNemar Cosmetic Surgery, San Ramon & Tracy, CA
Breast Augmentation Reconstruction PhotosDr. Pousti's Breast Reconstruction Photos - San Diego, CA
Breast Augmentation Reconstruction PhotosDr. Corbin's Breast Reconstruction Photos - Beverly Hills, CA


Florida Plastic Surgeons Breast Reconstruction Photo Gallery & FAQ

Breast Augmentation Reconstruction PhotosDr. Leonard Hochstein Breast Revision Photos - Miami ~ Aventura, Florida

Breast Augmentation Reconstruction PhotosDr. Simon's Breast Reconstruction Photos - Fort Lauderdale, Florida

Breast Augmentation Reconstruction PhotosDr. Hasen's Breast Reconstruction Photos - Naples, Florida

Breast Augmentation Reconstruction PhotosDr. Edison's Breast Reconstruction Photos - Hollywood & Miami, Florida


Maryland Plastic Surgeons Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosDr. Cohen's Breast Reconstruction Photos - Westminister, Maryland

Nevada Plastic Surgeons Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosReconstructive Breast Surgery Photos ~ Bongiovi Center for Plastic Surgery ~ Las Vegas, Nevada


New Jersey Plastic Surgeons Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosDr. Fiorillo's Breast Reconstruction Photos - Pearl River, NY & Westwood, NJ

Breast Augmentation Reconstruction PhotosDr. Friedlander's Breast Reconstruction Photos - Short Hills, NJ


New York Plastic Surgeons Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosBreast Reconstruction Photos - Dr. Robert Freund, New York & Long Island, NY

Breast Augmentation Reconstruction PhotosDr. Fiorillo's Breast Reconstruction Photos - Pearl River, NY & Westwood, NJ

Breast Augmentation Reconstruction PhotosThe Plastic Surgery Groups' Photos - Albany, NY

Breast Augmentation Reconstruction PhotosBreast Reconstruction Photos Dr. Freund - Manhattan & Long Island, NY

Breast Augmentation Reconstruction PhotosDr. Berger's Breast Reconstruction Photos - New York, NY


Pennsylvania Plastic Surgeons' Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosDr. Silberman's Breast Reconstruction Photos - Doylestown, PA


South Carolina Plastic Surgeons' Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosBreast Reconstruction - Carolina Plastic Surgery, Spartanburg, SC


Texas Plastic Surgeons' Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosBreast Asymmetry Correction - Dr. Byrd, Dallas, Texas
Breast Augmentation Reconstruction PhotosDr. Kunkel's Breast Reconstruction Photos - Fort Worth, Texas
Breast Augmentation Reconstruction PhotosDr. Pilcher's Breast Reconstruction Photos - San Antonio, Texas


Virginia Plastic Surgeons' Breast Reconstruction Photo Gallery

Breast Augmentation Reconstruction PhotosDr. Brown's Breast Reconstruction Photos - Herndon, Virginia

Midwest Plastic Surgeons Breast Reconstruction Before & After Photos

Breast Augmentation Reconstruction PhotosBreast Reconstruction Photos - Dr. Rucker, Wisconsin & Minnesota

Breast Augmentation Reconstruction PhotosBefore and After Breast Asymmetry - Dr. Rucker, Wisconsin & Minnesota

Breast Augmentation Reconstruction PhotosDr. Fedele's Breast Reconstruction Photos - Willough Hills, Ohio

Breast Augmentation Reconstruction PhotosGenesis Cosmetic Surgery Center and Medical Spa's Photos - St. Louis, MO

Breast Augmentation Reconstruction PhotosDr. Gerson's Breast Reconstruction Photos - Lake Geneva, Wisconsin

Breast Augmentation Reconstruction PhotosBreast Reconstruction Photos - Dr. Rios, Plastic Surgery & Dermatologic Institute, Chicago, IL

Breast Reconstruction Surgery Resources

Breast Reconstruction Information - Dr. Robert Goldstein & Dr. Heather Erhard, Bronx & Manhattan, NY

Breast Reconstruction Information - Dr. David Kim, Beverly Hills, CA

Breast Reconstruction Information - Dr. Joshua Korman, Mountain View, CA

Free-Flap Breast Reconstruction Information - Dr. Joshua Korman, Mountain View, CA

TRAM Flap Breast Reconstruction Information - Dr. Joshua Korman, Mountain View, CA

Breast Reconstruction - Dr. Kelly R. Kunkel, Fort Worth, TX

Breast Reconstruction - Dr. John T. Lettieri, Spartanburg, SC

Breast Reconstruction - Dr. Constantino G. Mendieta, Coconut Grove, FL

Breast Reconstruction - Dr. Sheryl G. Pilcher, San Antonio, TX

Postmastectomy Breast Reconstruction - Dr. Otto J. Placik, Arlington Heights, IL

Breast Reconstruction - Dr. Tom Pousti, San Diego, CA

Breast Reconstruction - Dr. Mary A. Powers, Long Beach, CA

Breast Reconstruction Information - Dr. Robert Rothfield, Weston, FL

Breast Reconstruction - Dr. Kimberly K. Short, Indianapolis, IN

Breast Reconstruction Information - Dr. David Silberman, Doylestown, PA

Breast Reconstruction - Dr. Peter J. Simon, Fort Lauderdale, FL

Breast Reconstruction - Dr. Kenrick A. Spence, Orlando, FL

Breast Reconstruction - The Plastic Surgery Group, Albany, NY

Breast Reconstruction Information - Janet Turkle MD Plastic & Cosmetic Surgery, Indianapolis, IN

Breast Reconstruction Information - Dr. Jennifer Walden, New York, NY

Breast Reconstruction Information - Dr. Steven Wallach, New York, NY

Breast Reconstruction Information - Dr. Laurence Weider, Dallas, TX

Breast Reconstruction Information - DR. Scott Zevon, New York, NY

Breast Reconstruction Information - Dr. Robert M. Freund, Manhattan & Long Island, NY

Breast Reconstruction Information - Dr. Brian Howard, Roswell & Cumming, GA

Post-Mastectomy Reconstruction Information - Dr. Kent Hasen, Naples, FL

Breast Reconstruction Information - Dr. David L. Abramson, New York, NY & Englewood, NJ

Breast Reconstruction Information - Dr. Mariam Awada, Southfield, MI

Breast Reconstruction - Dr. Gary S. Berger, New York, NY

Breast Reconstruction - Dr. Michael J. Brown, Herndon, VA

Breast Reconstruction - Dr. Frederic Corbin, Beverly Hills, CA

Breast Reconstruction Information - Dr. Richard Edison, Hollywood & Miami, FL

Breast Reconstruction Information - Dr. Beverly Friedlander, Short Hills, NJ

Breast Reconstruction Information - Genesis Cosmetic Surgery Center and Medical Spa, St. Louis, MO

Breast Reconstruction Using Tissue Expander Implant - Dr. Gregory M. Fedele, Willough Hills, OH

Breast Reconstruction - Latissimus Dorsi Flap - Dr. Gregory M. Fedele, Willough Hills, OH

Breast Reconstruction - TRAM Flap - Dr. Gregory M. Fedele, Willough Hills, OH

Breast Reconstruction Information - Dr. Michael Fiorillo, Pearl River, NY & Westwood, NJ

Breast Reconstruction - Dr. Gregory Fedele, Willough Hills, OH

Breast Reconstruction - Dr. Frank J. Ferraro, Ridgewood, NJ

Breast Reconstruction - Dr. Robert M. Gerson, Lake Geneva, WI

Breast Reconstruction - Dr. Scot B. Glasberg, New York, NY

 

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