Thank you for your questions and for providing the photos. Based on the photos, it does look like you initially had a double bubble deformity, which can be created when the implant's radius is more than the distance from the nipple to crease. In some cases, the crease is lowered to fit an oversized implant, and the remnant of the crease creates the double bubble.
In your case, over time, the skin stretched and the double bubble resolved. Unfortunately, as the skin stretched, the implant descended and your breasts bottomed out. This can occur when your skin and soft tissue cannot support the weight of the implant. Correction of this requires something to aid in the support of the implant, usually in the form of a sling. This acts like an interior hammock to support the implant, and typically uses either Strattice or Siri. In many cases, a lift is not necessary, as the nipple height is proper.
I would suggest visiting the plastic surgeon who performed your procedure and ask what his/her thoughts on its correction are.
Best of luck with your breasts.
Yes, your double bubble did stretch out over time, but you have bottoming out of both. A revision if you desire can be performed.
Your pictures are very helpful. Initially after surgery you did indeed have a double bubble which resolved, but with implants that are somewhat lower than your original inframmary fold (which we would call bottoming out). However, over the last 9 years your implant position has been stable. Replacing the implants with repositioning of the implants more superiorly would take care of your issues. There are several techniques for moving an implant up and stabilizing the position. Some are more successful and some are more involved than others. It is best to consult a surgeon experienced in this type of revision surgery.
Sometimes the implant will slip under the natural crease of the breast and give you 2 demarcated breast creases, (the implant and natural crease - a double bubble) and ultimately slide down the chest wall making the nipples appear too high (bottoming out). They are variations in degree of the same process. You may need elevation and support from mesh. See an experienced board certified plastic surgeon.
It looks like you have had internal stretching of the pockets and the lower breast. In addition, in some pictures, it looks like your left implant is falling too far laterally. You will need an in person exam to determine the exact treatment, but I believe that you will benefit from internal plication of the breast pockets and reinforcing the plication with an internal mesh.
Yes asymmetry. No no ptosis. Need larger implants with fat grafting in my over the internet opinion.