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This case demonstrates how when an implant “bottoms out” what can happen to the overall appearance of the breast. he preoperative photos demonstrate upward pointing nipples as a result of the implants dropping below the infra-mammary fold or crease. Utilizing strategically placed internal sutures, quite similar to an underwire bra, the breast appearance has dramatically improved. The nipples no longer point towards the ceiling, there is increased cleavage and more symmetric distribution of the breast’s fullness.