Medical Tourism Blog
Revise Your Look: Bottoming Out Implants with Revision Breast Surgery in Korea
Table of contents
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- Revision Breast Surgery: Comprehensive Medical Procedures
- Best Clinics in Korea
- The Medical Tourist's Guide: Revision Breast Surgery in South Korea
- Cost Analysis: South Korea vs. Global Medical Tourism Destinations
- Patient Experiences and Outcomes After Revision Breast Surgery for "Bottoming Out" Implants
- Conclusion
Breast augmentation is a popular cosmetic procedure that can bring transformative results. However, like any surgery, it carries risks, including a complication called "bottoming out" of breast implants. This condition can affect both the look of the breasts and patient confidence. This guide explains what "bottoming out" is, explores advanced [revision breast surgery](/blog/revision-breast-surgery-korea) options to fix it, and offers insights for those considering South Korea as a top destination for this specialized care. The aim is to provide clear, compassionate, and practical information to help individuals make informed choices on their path to restored comfort and aesthetic satisfaction.
"Bottoming out" occurs when a breast implant shifts downward beyond its intended position, causing the breast to look unnaturally elongated. Specifically, the implant drops below the inframammary crease—the natural fold where the breast meets the chest wall. This shift disrupts the breast’s natural proportions and often makes the nipple appear too high on the breast mound.
This issue is also known by other terms such as "lower pole stretch" or "inferior implant malposition," which emphasize the stretching of the lower breast tissue under the implant’s weight and gravity. Other related terms include "low malposition" and "implant displacement." While sometimes confused with "double bubble deformity"—where breast tissue overlaps the implant creating a secondary bulge below the nipple—"bottoming out" is distinct. It’s important to differentiate it from other implant malpositions like implants sitting too high (high malposition), too far apart (lateral malposition), or too close together (symmastia).
Several factors contribute to "bottoming out," often involving a mix of surgical technique, implant features, tissue quality, and post-operative care.
Contributing Factors to "Bottoming Out"
- Surgical Technique: If the implant pocket is made too large or positioned too low, or if the inframammary fold is overly released during surgery, the implant lacks support and can slip downward. Over-dissection reduces tissue available to hold the implant.
- Implant Characteristics: Larger, heavier implants put more strain on breast tissue and skin, increasing the risk of slipping over time. "Bigger is not necessarily better" for long-term stability. Bottoming out can happen with any implant type or incision method.
- Tissue Quality and Anatomy: Thin, weak, or lax breast tissue is more prone to bottoming out. Aging, pregnancy, breastfeeding, weight loss, and genetics can weaken tissue. Even patients with tight tissues (Type I breast) may face risks. Submuscular implant placement (under the muscle) generally offers better support than subglandular placement (above the muscle).
- Gravity and Time: Gravity and natural aging reduce skin elasticity, causing implants to descend gradually, especially larger ones.
- Lifestyle and Post-Operative Activity: Strenuous activity too soon after surgery, inconsistent use of support bras, premature wearing of underwire bras, and smoking all increase the risk of implant movement and complications.
The causes of bottoming out are complex and often involve multiple factors. Preventing and correcting it requires a personalized approach from the surgeon and careful patient compliance. Selecting a highly qualified surgeon and discussing realistic implant sizes are key steps in prevention. Both patient education and surgeon transparency are essential.
Recognizing the Signs of "Bottoming Out"
Early detection helps ensure timely treatment. Signs include:
- Visual Changes: Nipples pointing upward instead of straight ahead, increased distance between nipple and breast crease, bulging fullness in the lower breast, loss of upper breast fullness, asymmetry between breasts, visible scar lines above the crease (if inframammary incisions were used), and visible rippling or wrinkling of skin over implants.
- Sensory Experiences: Feeling that implants have dropped too low, pain or discomfort around breasts or incisions, chest pressure, or loss of nipple sensation. Symptoms may appear months or years after surgery.
Bottoming out can happen soon after surgery due to technical issues or develop gradually from tissue stretching. This distinction guides the corrective approach—either restoring anatomical support or reinforcing tissue strength. A thorough pre-operative assessment is crucial to identify whether the problem is isolated lower pole stretch, inframammary fold migration, or a combination.
Revision Breast Surgery: Comprehensive Medical Procedures
Revision breast surgery, or secondary breast surgery, corrects or improves previous breast surgeries. It addresses complications, enhances aesthetics, or adapts to natural changes and patient preferences. Breast implants are not lifetime devices and often require removal or replacement after 10 to 15 years. Reoperation rates after primary augmentation can be as high as 36%. Revision surgery is usually more complex due to scar tissue and altered anatomy.
Specific Surgical Techniques for Correcting "Bottoming Out"
Fixing bottoming out requires a tailored approach based on cause, severity, and patient anatomy. Surgeon expertise in diagnosis and technique selection is critical.
- Pocket Adjustment and Internal Sutures (Capsulorrhaphy): Tightening the implant pocket with internal sutures repositions the implant and prevents further downward movement by creating a new inframammary fold. This works well for moderate cases but may not last if tissues are very thin.
- Acellular Dermal Matrix (ADM) or Surgical Mesh ("Internal Bra" Technique): For severe cases or weak tissue, ADM or mesh acts as a scaffold or internal bra, reinforcing the lower breast tissue and supporting the implant. Materials like Strattice, GalaFlex, and Galaform provide long-term structural support as natural tissue grows into the matrix. This technique addresses tissue laxity and gravity, offering more durable results than sutures alone.
- Implant Exchange (Size, Type, or Plane Change): Removing old implants and replacing them with smaller or different types (e.g., saline to silicone) can reduce strain. Changing implant placement from subglandular to submuscular adds muscle support. The pocket may be resized with sutures to fit smaller implants.
- Breast Lift (Mastopexy) with Revision: Often combined with revision to remove excess skin and reshape sagging breasts, improving breast profile and nipple position. Additional incisions may be needed.
- Neopectoral Pocket Creation: Creating a new pocket may be necessary in severe stretch deformities or compromised original pockets.
- Fat Grafting: Adding or reducing volume and correcting contour irregularities can enhance soft tissue coverage and natural appearance.
The Surgical Process and Expected Recovery
Revision surgery usually takes 1 to 3 hours under general anesthesia. Surgeons often reuse original incisions but may create new ones if needed. Implants are removed, scar tissue excised, and new implants placed if planned. Many procedures are outpatient, but complex cases may require overnight hospital stays.
Recovery is often easier than initial augmentation since the pocket exists. Patients wear compression garments or surgical bras to reduce swelling and support healing. Temporary drains may be used. Assistance is recommended for the first few days.
Swelling, bruising, and discomfort peak in the first week and are managed with medication and rest. Light activities resume by weeks 2-3, with gradual return to exercise by weeks 4-6. Strenuous activities like golf and tennis usually resume around 6 weeks. Final breast shape settles by 6-12 months. Postoperative taping and consistent use of underwire bras for 6 weeks to 3 months support optimal results. Follow-up visits monitor healing and remove stitches.
Success depends heavily on patient adherence to post-operative care and long-term supportive measures. Surgical correction is only part of the solution; protecting the outcome is equally important.
Best Clinics in Korea
Listed below are the best clinics in Korea:
| Clinic Name | Key Features | Special Techniques |
|---|---|---|
| Okay Plastic Surgery Clinic | Premier destination for bottoming-out implant correction in Korea; led by Dr. Cho, expert in breast surgery; transformative approach prioritizing sincerity, precision, and personalized care; supported by specialized professionals and cutting-edge medical technology; comprehensive breast services including augmentation, reduction, and corrective surgeries | Advanced breast surgical techniques for complex cases involving significant breast reduction and severe implant complications |
| THEPLUS Plastic Surgery | Premier clinic for bottoming-out implant procedures; exceptional team of board-certified surgeons; patient-centered approach prioritizing safety and natural results; located in Garosu-gil, Gangnam, Seoul with four floors dedicated to patient journey; surgeons active in international medical research and education | Expertise in 3D implants, rhinoplasty, facial contouring, and breast augmentation; personalized treatment plans emphasizing harmonious and natural enhancements |
| Seojin Plastic Surgery Clinic | Led by Dr. Lee Hyungmin with over 16 years experience; performed over 2,300 breast surgeries; recognized as one of Korea’s Top 100 Good Doctors in 2022; offers personalized care as a one-doctor clinic; active in Motiva and Mentor academic conferences | Microscale Dual Plane Technique, 3D Spatial Dissection, 3D breast implant modeling, free implant trial bra service, hybrid breast augmentation combining implants with fat grafting enhanced by PRP |
Okay Plastic Surgery Clinic
Okay Plastic Surgery Clinic stands out as the premier destination for bottoming-out implant correction in Korea, led by the esteemed Dr. Cho, a specialist renowned for her deep expertise in breast surgery. Dr. Cho’s extensive research and published work in the field underscore her commitment to advancing breast surgical techniques, particularly in complex cases involving significant breast reduction and severe implant complications that many clinics are unable to address. At Okay Plastic Surgery Clinic, patients benefit from a transformative approach that prioritizes sincerity, precision, and personalized care, ensuring tailored solutions that align with each individual’s unique needs and aesthetic goals. Supported by a team of specialized professionals and cutting-edge medical technology, the clinic offers comprehensive breast services, including advanced augmentation, reduction, and corrective surgeries, making it the trusted choice for those seeking expert treatment for bottoming-out implants and other challenging breast conditions in Korea.
You can check out their website here: Okay Plastic Surgery Clinic Website
THEPLUS Plastic Surgery
THEPLUS Plastic Surgery stands out as the premier clinic for bottoming-out implant procedures in Korea due to its exceptional team of board-certified surgeons, cutting-edge facilities, and a patient-centered approach that prioritizes safety and natural results. Led by renowned experts such as Dr. Kim, an award-winning researcher in 3D implants and a global authority in rhinoplasty and facial contouring, and Dr. Jeong, President of the Korean Society of Plastic Surgeons with extensive experience in combining function and beauty, THEPLUS offers unparalleled expertise. Dr. Lee’s specialization in breast augmentation further enhances the clinic’s comprehensive capabilities. Located in the vibrant Garosu-gil area of Gangnam, Seoul, THEPLUS is equipped with four floors dedicated to every stage of the patient journey, from consultation to post-operative care. The clinic’s surgeons are not only skilled practitioners but also active contributors to international medical research and education, ensuring that patients benefit from the latest advancements in implant techniques. This commitment to excellence, combined with personalized treatment plans that emphasize harmonious and natural enhancements, makes THEPLUS Plastic Surgery the best choice for those seeking bottoming-out implant correction and other advanced cosmetic procedures in Korea.
You can check out their website here: THEPLUS Plastic Surgery Website
Seojin Plastic Surgery Clinic
Seojin Plastic Surgery Clinic stands out as the premier destination for bottoming-out implant procedures in Korea due to its unparalleled combination of expertise, advanced technology, and personalized care. Led by Dr. Lee Hyungmin, who has over 16 years of experience and was recognized as one of Korea’s Top 100 Good Doctors in 2022, the clinic has performed more than 2,300 breast surgeries, demonstrating a deep mastery of breast augmentation and corrective techniques. Seojin Clinic’s innovative approach includes the Microscale Dual Plane Technique and 3D Spatial Dissection, which are tailored to each patient’s unique anatomy to ensure precision and natural results while minimizing complications like bottoming-out. The clinic also offers cutting-edge services such as 3D breast implant modeling and a free implant trial bra service, allowing patients to visualize and experience their results before surgery. Additionally, Seojin’s hybrid breast augmentation method, combining implants with fat grafting enhanced by PRP, provides a softer, more natural contour and improved implant longevity. With active participation in Motiva and Mentor academic conferences, the clinic stays at the forefront of implant technology and surgical trends. As a one-doctor clinic, Seojin guarantees comprehensive, attentive care throughout the entire process, making it the trusted choice for patients seeking safe, effective, and aesthetically superior solutions for bottoming-out implants in Korea.
You can check out their website here: Seojin Plastic Surgery Clinic Website
The Medical Tourist's Guide: Revision Breast Surgery in South Korea
South Korea is a top global destination for medical tourism, especially cosmetic surgery. It is known for cutting-edge technology, highly skilled surgeons, and competitive pricing. In 2023, South Korea welcomed 1.17 million foreign medical tourists, with plastic surgery a major draw. The government aims for 700,000 foreign patients annually by 2027. Seoul’s Gangnam district is famous for world-class cosmetic clinics staffed by board-certified surgeons who emphasize natural, lasting results and patient safety.
South Korea offers more than expertise and cost advantages. Its patient journey includes virtual consultations, travel and accommodation assistance, thorough pre-surgical evaluations, and dedicated post-operative care with strong language support. This comprehensive system reduces stress for international patients.
Step-by-Step Patient Journey for Medical Tourists
- Initial Virtual Consultation and Surgical Planning: Online consultations allow patients to discuss concerns and goals with expert surgeons, set expectations, and develop a customized plan.
- Travel and Accommodation Arrangements: Clinics assist with travel and lodging, offering options from luxury hotels to budget stays near the clinic. Some packages include airport transfers.
- Pre-Surgical Examinations and In-Person Consultation: Upon arrival, patients undergo physical exams, tests (blood work, imaging), and psychological evaluations to confirm fitness for surgery.
- Surgical Procedure and Immediate Post-Operative Care: Surgery is performed with precision to minimize trauma. Patients stay in private hospital rooms for 24 hours under observation.
- Structured Recovery and Follow-up: Regular check-ups, wound care, and pain management are provided. Patients usually stay 1-2 weeks post-surgery for monitoring.
- Language and Communication Support: Multilingual staff and translators ensure clear communication.
- Cultural and Leisure Activities: Patients often explore Korea’s culture and scenery during recovery to enhance their experience.
Many clinics offer "all-inclusive packages" covering surgery, anesthesia, operating room, tests, overnight stays, and post-op care. However, travel and accommodation costs may not always be included, so patients should clarify package details and request itemized quotes to avoid surprises.
South Korea’s specialization in procedures like revision breast surgery means surgeons often have deep expertise, which can improve outcomes for complex cases.
Cost Analysis: South Korea vs. Global Medical Tourism Destinations
Understanding the Cost of Revision Breast Surgery in South Korea
Revision breast surgery in South Korea typically costs between ₩13,000,000 and ₩22,000,000 KRW (about $8,944 to $15,136 USD as of May 2025). Some breast augmentation packages start as low as $7,999 USD.
Prices usually include surgeon fees, anesthesia, operating room use, pre-surgical tests, overnight stays, and post-operative care. Some packages add medical insurance, accommodation, and airport transfers. A 10% deposit is often required to secure surgery.
Costs vary based on surgery complexity, surgeon reputation, clinic location, implant type and size, and care extent.
Comparative Costs for Revision Breast Surgery (USD)
| Country | Procedure Type | Cost Range (USD) | Typical Inclusions/Considerations |
|---|---|---|---|
| USA | Breast Augmentation | $10,000 - $12,000 | Surgeon, facility, anesthesia, meds, garments, tests |
| Revision Breast Surgery | $28,200 - $170,000 | Highly variable based on complexity | |
| South Korea | Revision Breast Surgery | $8,944 - $15,136 | Surgery, pre-op tests, overnight stays, post-op care |
| Breast Implants (general) | $3,000 - $10,900 | Varies by surgeon and technique | |
| Thailand | Breast Implants (general) | $3,500 (2021 data) | |
| Revision Breast Surgery | $4,200 - $17,200 | ||
| Turkey | Breast Augmentation | $5,500 - $6,000 | Often includes tests, post-op care, accommodation, transport |
| Revision Breast Surgery | $4,800 - $17,200 | ||
| United Kingdom | Breast Augmentation | $10,000 - $12,000 | High-quality care; often excludes accommodation/post-op care |
| Europe (General) | Breast Augmentation | $8,500 - $9,500 | Competitive pricing; often excludes travel and accommodation |
| Malaysia | Revision Breast Surgery | $8,000 - $13,500 | Includes insurance, tests, accommodation, transfers |
South Korea offers competitive pricing compared to Western countries, where revision surgery can be much more expensive. Other medical tourism hotspots like Thailand, Turkey, and Malaysia also provide competitive rates, sometimes lower than South Korea’s.
However, patients must consider additional expenses such as flights, accommodation during recovery (1-2 weeks), local transport, and daily living costs. These can add up and sometimes offset surgical savings. Getting a detailed, itemized price quote before traveling is essential. Prioritizing safety and quality over just low cost is crucial.
Patient Experiences and Outcomes After Revision Breast Surgery for "Bottoming Out" Implants
Patients undergoing revision surgery for bottoming out generally report positive outcomes, with improved aesthetics and satisfaction.
Outcomes of Revision Surgery for "Bottoming Out"
Revision surgery repositions implants correctly, restores the inframammary fold, and provides strong internal support. Techniques using Acellular Dermal Matrix (ADM) or surgical mesh show high success rates—studies report a 95.5% success rate and only 5% complication rate with ADM in breast reconstruction. This is much better than the 36% reoperation rate after primary augmentation. The "internal bra" technique supports the breast like a hammock, delaying sagging and offering durable results.
Aesthetic and Functional Improvements
Patients see correction of unnatural breast elongation, restored upper breast fullness, and better nipple positioning. This leads to symmetrical, natural-looking breasts and boosts confidence. The surgery can also relieve discomfort or pain caused by implant malposition.
Long-Term Durability and Patient Satisfaction
ADM and mesh provide internal scaffolding that integrates with natural tissue, maintaining breast shape and position over time. An internal bra lift can last 10 years or more. However, long-term success depends on patient adherence to post-op care, maintaining healthy weight, avoiding smoking, and wearing supportive bras. Regular self-exams and imaging help monitor implant condition. Surgical correction is only part of the journey; protecting the results through disciplined care is equally important.
Conclusion
"Bottoming out" of breast implants is a correctable complication caused by a mix of surgical, anatomical, implant, and post-operative factors. Advanced revision breast surgery offers effective solutions to restore breast aesthetics and comfort. Techniques like pocket adjustment, implant exchange, breast lift, and especially the use of Acellular Dermal Matrix or surgical mesh provide durable support addressing tissue weakness. South Korea stands out as a premier medical tourism destination for revision surgery, combining expert surgeons, advanced technology, and comprehensive patient care. Achieving lasting success depends on choosing a skilled surgeon and the patient’s commitment to realistic expectations and diligent post-operative care.
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