Breast augmentation - am I experiencing double bubble/bottoming out? (Photo)

Question

I’m about a month post op from my breast augmentation and I have concerns about double bubble and/or bottoming out? It looks especially noticeable if I’m moving my arm or using my pec muscles a certain way. I used to work out my chest muscles (not too much) before I got my breast augmentation so I’m hoping this fades away eventually...

Dana Goldberg, MD · Answer

When implants are placed under the muscle, you can sometimes see contraction of muscle fibers over top of the implant.  this is somewhat unavoidable and some patience and may change over time. It’s not a complication, and I don’t see anything wrong with your implants.  If you want to get rid of animation deformity, you can try tissue slings or subglandular placement. Both of these have risks as well, so it’s often better to leave well enough alone.

Martin Jugenburg, MD · Answer

Thanks for your question...It does not appear you have bottoming out. It appears to be your flexed chest muscles changing the shape of the implants. Please see your surgeon if you are still concerned. You can learn more on our social media (Instagram and Snapchat): @realdrsix.
  
Regards,

Yannis Alexandrides, MD, FACS · Answer

From your photos I do believe this is a double bubble. The old fold is showing just above the new fold that the surgeon has created.

Nathan Eberle, MD, DDS, FACS · Answer

a double bubble, that is called an animation deformity. when implants are placed under the pec muscle this commonly occurs.

Jean-Pierre Riou, MD · Answer

The surgeon did a great job! You have a beautiful result! There is neither a double bubble nor bottoming out. The depression that you see on the bottom is typical "animation deformity" and occurs frequently in the submuscular position (under the muscle). You only see it when you contract the Pectoralis Major, great photos by the way, it makes it very clear. The lower breast is smooth and not bottomed out in the photo of your chest at rest. This will not go away but most patients get use to it. This is certainly one of the disadvantages of going behind the muscle along with greater post op pain. The great ADVANTAGE is that there is significantly less Capsular Contracture rates (Hardening, pain and distortion of shape) and contracture is one of the most dreaded complications for the patient and the surgeon. I have placed over 8,000 implants in the last 24 years and have recorded a contracture rate of 1.3% for my Saline Series. Discuss it further with your surgeon, I'm sure he or she would be more than happy to go over it with you.

Daniel Barrett, MD · Answer

Dear batiexo,Bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question and photograph.  Two of your photographs indicate a fantastic result.  Two indicate that you may be flexing your pec muscles and therefore noticing a bubble on the right breast in one photograph and on the left breast is the other photograph. Without an examination it is difficult to comment with certainty if you are flexing your muscles or if in fact you do have a double bubble.  My advice is to follow up with your plastic surgeon for an in-person examination.  Best of luck.

Daniel Schmid, MD · Answer

Double bubble is when the implant has fallen below the inframammary crease (ie the fold under the breast).  It does not appear that this is happening.  It seems that you can see the pectoralis flexing in some of the pictures.  This can be normal for some time after an augmentation.  This is likely the case.  Follow up with your surgeon.

Darryl J. Blinski, MD · Answer

Based upon the series of before and afters photos posted & your history of pectoral muscle exercising, I se "double bubble" effect. No bottoming is noted. My over the RS internet guess would have used "dual plane" implant position since strong pectorals causes the double bubble effect.

Camille Cash, MD · Answer

It is difficult to tell from your photos if there is a double bubble developing as some indicate there could be while others don't.  I recommend following up with your surgeon.  An exam will better reveal what is occurring.  Don't panic as it may just be normal healing as you are early in recovery.

Breast augmentation - am I experiencing double bubble/bottoming out? (Photo)

Answers (11)

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