Is what I'm experiencing bottoming out and double bubble? Do I need a lift? (Photo)

My surgery was performed in Sept 2005. Immediately following my surgery I complained to my surgeon that I thought one of my implants was larger then the other, and that I could see the infra mammary creases high up on my breasts. He assured me that it would resolve itself over time. After a year passed, that seemed to be the case, however one implant still looks larger then the other, my symmetry looks off, and the smaller of the two breasts seems to be sagging. Thoughts/Suggestions? Thanks!!

Doctor Answers 6

Bottoming out and a double bubble

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.
Jeff Rockmore

Albany Plastic Surgeon
5.0 out of 5 stars 71 reviews

Bottoming out and double bubble

Yes, your double bubble did stretch out over time, but you have bottoming out of both.  A revision if you desire can be performed.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Bottoming out or do I need a lift?

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.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 97 reviews

Bottoming out or double bubble

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.

Mark E. Crispin, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 23 reviews

Is what I'm experiencing bottoming out and double bubble? Do I need a lift?

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.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 73 reviews

Is what I'm experiencing bottoming out and double bubble? Do I need a lift?

Yes asymmetry. No no ptosis. Need larger implants with fat grafting in my over the internet opinion. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.