22, 440cc, Motiva, smooth round, extra high, is this a double bubble deformity? How can it be fixed? (Photos)

Your implants are beginning to bottom out from the weight. I would suggest going smaller and tightening the lower pocket. You might even need mesh for support. This happens when tissue does not support the weight of the implants. To prevent it from becoming worse, always wear good supporting bras.

Dear samxxbot,
though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Maybe. It looks like a bit too much distance and skin excess between nipple and medial inframammary fold. The way the implant hangs in the loose skin allows the folding or deformation of the implant shell that is causing this appearance. This might be improved by tightening up the capsule in that area and taking up some of the slack.
However, we are not being shown an animation view, with flexion of the pectoralis muscles. There is the possibility that the surgeon over-released the pectoralis too high on its medial insertion on the sternum. That is a different situation and harder to correct and would likely need some kind of mesh or ADM to close off that space.
An in-person exam with a board-certified plastic surgeon would be needed to tease out these subtleties.