Do I Have Bottoming out and Double Bubble? (photo)

i had tubular breasts and got 325cc implants overs in 2005 a few months after i went to get my areolas reduced in the hope it would fix my double bubble. it worked on my right nipple but not my lef please could you help me i also think i have bottoming out.

Doctor Answers 11

Correction of a double bubble

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is a tough problem.  It looks like the fold under  your breast was not adequately released which can happen and in addition to this your implant bottomed out.  It maybe best to change to a new pocket and change implant size.  There should be enough scar capsule to close to elevate the implants but you might also need a piece of alloderm or tigr mesh to help support the implant in a  new higher position.  I would get several opinions before proceeding and as  your revision rate is high I would make certain you know about the PS policy on paying for revisions.

La Jolla Plastic Surgeon
5.0 out of 5 stars 32 reviews

Bottoming out and tuberous issue

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I think that the bottoming out can be treated along with possible going with a smaller implant an exam in person would give me more information to see if you need a lift as well.  Good luck. FYI, it may take more than one procedure to get this right.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Double bubble deformity and bottoming out

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for posting your photos.   I have treated your condition many times.   It will require revisional surgery.  The procedure would likely entail some work on  your capsule around the implant.   To correct for your bottoming out and reposition your implant, I would likely recommend use of Strattice (collagen sheet) for an internal bra technique.  In addition, if you have loose excess skin, a lit may also be needed.  Please visit with a board certified PS with experience with revisional implant surgery for a consultation. 

Dr. Basu

Houston, TX

Do I Have Bottoming out and Double Bubble? (photo)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You have severe double bubble deformity,which can be very difficult to correct

I have found that using an adjustable implant is of great benefit .Th inframammary fold needs to be re fixated, the internal constrictions released and then expansion need to be performed to achieve the desired volume  

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Double Bubble after Tuberous Breast Correction

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

   With a very constricted tuberous breast, lowering of the fold is necessary.  Double bubble is always a possible outcome.  Your breasts can definitely be improved but this will require a great deal of manipulation.  Find the plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year.  Kenneth Hughes, MD Los Angeles, CA

Tuberous breast shapes

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You would appear to have a double bubble shape following your breast augmentation.  It is clear that you have a tuberous breast shape bilaterally.  Correction has to be offered to downsize the areolae as well as a major reduction in the size of the implants, in my opinion.  You will still need some internal inferior breast fold surgical release, but  just how much of this technique would not be known until the surgery was being performed.


Please contact your local Plastic Surgeon for further advice about this, or obtain other opinions from local Plastic Surgeons in your community.


Frank Rieger M.D.

Fixing double bubble after tubular breast

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are a number of variations in tubular breast and the double bubble deformity is common after implants. The areolar reduction was probably a good idea and you may benefit from having it done again, but with more redistribution of the breast tissue. A specific recommendation would need an in-person consultation.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Correcting constricted breasts requires release of the connective tissue at the base of the breast.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A constricted or tubular breast exists because the base of the breast against the chest wall is too narrow. During augmentation this should be released to allow the base to some the diameter of the breast implant. Done inadequately, a double bubble will result.

Correction of Double Bubble after Breast Augmentation and Constricted/Tuberous Breasts??

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I'm sorry to see/hear about the complication you have experienced after breast augmentation and correction of tuberous breast deformity.  Revisionary surgery will likely involve manipulation of the breast implant pockets as well as manipulation of the nipple/areola/ glandular tissues.

 For example, it may be helpful to use internal sutures (capsulorraphy) to decrease the size of the breast implant pockets. Doing so may allow for the use of smaller breast implants that will be a better "fit" for the overlying breast tissues.

 Manipulation of the nipple/areola/glandular tissue may involve areola reduction and/or excision of glandular breast tissue;  this maneuver may help the breast tissue and the underlying breast implant to “behave” more like a single unit as opposed to the “double bubble”.

 Sometimes, in order to avoid complications, it is best to have the procedures performed in stages. When the time is right, seek consultation with well experienced plastic surgeons who can demonstrate significant experience helping patients in your situation.

 You may find the attached link helpful to you as you do your research.

Best wishes.

Double bubble breast deformity

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Tuberous breasts are the toughest starting point for breast augmentation surgery.  You have a double bubble deformity because the old inframammary fold is still present indenting the breast above the new fold that was created by your surgeon.  So, this is not as much bottoming out as it is a double bubble.  Repairing this is complex and not always successful.  You should revisit this with your doctor and seek some other expert opinions in your area.

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.