I am noticing the formation of a double bubble. Am I Starting to Bottom Out? (photos)
Doctor Answers 28
How patient are you?
Breast Implant Double Bubble or Bottoming Out Repair- Wait 6 months
Thank you for your question. You do appear to have a Breast Implant Double Bubble on your photos.
When this happens you will need a surgical repair of your Inframammary Crease-the fold beneath your natural breast. Double Bubble rarely, if ever, heals on its own.
Of course consult your Plastic Surgeon about repair. Typically repair is done at 6 months after the Breast Augmentation to allow the full extent of the repair required to become fully evident.
Your breast implants are not bottoming out.
All breast implants will 'settle' a llittle in time.. Yours look just fine, and I would leave them alone. Going to a larger size sill not improve the appearance, and would be pretty big for your figure.
The 'double bubble' comes from putting large implants into a small breast. Bigger implants will make it worse or make the upper pole too prominent.
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Right size implants for optimal asethetic result
Your implants seem to be bottoming out most likely due to migration of implants downward beyond the natural breast fold. The solution will be to remove the implants, repair and re-establish the natural breast fold by closure of the lower pockets using heavy, absorvable suture material. I do not reccomend going to larger size implants at this time because the excess weight of the implants may rupture the repair resulting in reccurrence of your problem.
Settling vs. Bottoming Out
From your photos, it appears that you have had settling of the implants, rather than bottoming out, which will cause the nipples to point too high.
The "double bubble" crease would be made worse by a larger implant. If it disturbs you enough to have further surgery, this can sometimes be improved. Best to consult your surgeon about that possibility, but allow about 6 months for all the tissues to settle first.
Bottomed out implants
Bottomed out implants are cases that I look forward to because I know how to fix them. It depends on the etiology of the failure and sometimes it is because of your tissues. Even in this case we are aware of how to fix the deformtiy. Your left side may have not been released enough internally to make that shadow of the fold go away but now that the fold is visible, you likely will need a revision surgery. I've not seen this settle out on it's own. Some may not have seen the fold that bad in your photos, but in their offices they would have. We all see/saw this sort of thing and usually don't like seeing it so either do it in Canada or in SA, but if yo're not sure about the result you can always go to another board certified plastic surgeon.
Not bigger implants
It looks like you are bottoming out, and you may be better off downsizing and raising the fold back up as well.
Yes you are bottoming out with a visible double bubble. This will not self correct and going bigger will make it harder for the repair to work. It's not that easy..
Implants are moving below your breast crease
It looks like your implants are lower than your breast fold. You can have this repaired by removing the implant and repairing the inframammary fold. It would be best to wait about 3 months for swelling to decrease and the implant to settle. If you decided to increase the size of your implant, the chance of bottoming out or sagging of the breast itself would actually be a little bit higher. We don't know exactly what size you need to stay below to decrease this risk significantly but a good guess is about 400cc.