Double Bubble Vs Bottoming Out After Breast Implants

Breast augmentation is a wonderful procedure that can restore shape, body proportion and confidence to any patient.  But there are several long-term potential problems that can occur that must be recognized and treated.   The “double bubble” and the “Bottoming out” deformities are two of them.

Double Bubble Deformity

When breast implants are initially placed, they tend to “ride high” or sit more superior in relation to the breast tissue.  With time and often with the help of a special bra they will descend over the course of 3-4 weeks finally settling directly behind the breast mound.  The “double bubble” deformity is when the breast tissue descends instead of the implant.  This may occur with age, loss of weight or pregnancy.  In this case the breast tissue falls and therefore the implant now gives more fullness in the superior part of the breast.  Hence from the side one sees the convexity of the implant than the convexity of the breast below it.  This is also called breast ptosis.

Bottoming Out Breast Implants

Preventing the implants from dropping too low requires a few basics.  First, the inframammary fold or the crease below the breast must not be violated when forming the implant pocket.  Second, the deep tissues at the inframammary fold must be resutured to the chest wall fascia.  If these two principles are adhered to then the implants will stay where they need to.  If not, the implants can fall below the central mound of the breast creating more fullness below the nipple rather than behind it.  Hence “bottoming out.”

Breast implant revision surgery can correct each of these deformities. The “bottoming out” scenario requires reestablishment of the inframmanry fold and deeper breast tissues to move the implant superiorly.  Correction of the “double bubble” requires a mastopexy to elevate the breast mound. Review the double bubble and bottoming out before and after pictures.

If you’d like to talk about these issues or any cosmetic concern, contact us and schedule your complementary consultation.