PATIENT 14

“Bottoming out” or downward displacement is a common complication with both smooth and textured implants. This is because smooth never grip and textured implants rarely grip to the breast tissue. Therefore the implant is only supported by the skin and, with time, this may give way allowing the impkant to migrate downwards with the nipple remaining at the same height. This then looks like the nipple is too high on the breast and the breast is too low. P-URE foam implants nearly always grip like velcro to the breast tissue and are thus supported and do not exert the same force on the skin. They rarely displace which is why, unlike smooth and textured implants, they are guaranteed against displacment and rotation for 10 years.

Correcting bottoming out to give the least risk of it happening again needs replacement with P-URE foam implants with removal of the capsule so the foam can grip to new breast tissue. The implant pocket also needs to be modified to close and reinforce the excess space at the bottom. This is how Dr Fleming corrected this patient’s problem.