Gautami made her first appearance at the age of 17; in the Telugu film Dayamayudu that was produced by her cousin. She was studying at GITAM College in Vizag, Andhra Pradesh when she received her first film offer in Tamil industry through Guru Shishyan, a film that also starred Rajnikanth. She was most active in Tamil cinema from the late 80’s to the mid 90’s, and was a competitor to the other heroines of the time, Kushboo and Banupriya. Her filmography includes Thevar Magan, as well as Mani Ratnam’s “Iruvar” in 1997. She has acted almost with all the Tamil heroes of her time that includes Rajinikanth, Kamalhassan, Vijayakanth, Prabhu Ganesan, Karthik, Arjun Sarja, Arvind Swamy,Murali, Ramki, Rahman, Sarath Kumar whereas most movies with Sathyaraj and Ramarajan. She has done several films in Malayalam, notably His Highness Abdulla starring with Mohanlal, Dhruvam opposite to Mammootty, and Daddy against Arvind Swamy. She has also acted in the Kannada films Elu Suttina Kote, Chikkejamanru and Cheluva, and in the Hindi films Pyar Hua chori chori, Janata ki Adalat, Haiwan, Admi, Appoo Raja, Trimurti, and Dhaal. She has acted in the Tamil serial Indira in the lead role. She made a comeback to the film industry in the late 2000s as a costume designer for films starring her partner Kamal Haasan. After sixteen years, she returned to acting by starring in the Tamil film Papanasam in which she was paired with her partner Kamal Haasan. Gautami was married to businessman Sandeep Bhatia in 1998 with whom she has a daughter Subbalakshmi born in 1999. She divorced Sandeep Bhatia in 1999. Since 2005, she and actor Kamal Haasan have been in a live-in relationship. Gautami was diagnosed with breast cancer at age 35, and successfully fought against it.
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