I have Sientra Breast Implants 350cc, went from 34a to 34d. Am I Bottoming out or getting double bubble? (photos)

Your previous inframammary crease is still barely visible, but causes the double bubble appearance you see on your left breast. However, your nipple-crease distances appear to be symmetrical and well-placed.BTW, you had cohesive silicone gel implants, but the original "gummy bear" implants were the McGhan (Allergan) style 410 shaped, textured, cohesive gel implants. These are now FDA approved, but when they were in FDA studies, they acquired the lay public and media nickname "gummy bear" implants. All of the other silicone gel implants by all 3 USA implant manufacturers are also cohesive, but are typically somewhat softer, less rubbery, and slightly more natural in feel. Since all silicone gel implants are now (some degree of) cohesive, many surgeons and even more patients describe the latest generation of cohesive gel implants as "gummy bear" implants. Technically incorrect, yet still a different kind of cohesive similar to the true gummy bear style 410s.If your Sientra implants are textured, you have very little worry that they will drop too far, since the texture is designed to adhere to your tissue capsule. That scar capsule will mature, soften, and stretch over time, as will your skin, so this slight double bubble may well resolve over time. An elastic bandeau may help; ask your surgeon.Revision is unlikely to be necessary, but it will take a full 6-12 months to answer that definitively. I actually think you look pretty good (for what I assume your pre-op anatomy to have been) at this point in your recovery. Be patient and glad that you chose a good surgeon! Best wishes! Dr. Tholen

Your post-operative pictures suggest the presence of a
persistent inframammary fold and a mild double bubble deformity.This is not uncommon when the distance from
the areola to the new inframammary fold is increased to accommodate a larger
breast implant.Under these
circumstances, it’s not unusual for patients to feel their breast implants
beneath the level of the old inframammary fold especially if they’re thin and
have minimal breast tissue.In the
vast majority of patients, this problem improves with the passage of time.Under these circumstances, the weight of the
implant stretches and expands the soft tissue.If this problem persist beyond six months, revisional surgery may be
necessary. It’s
important to discuss these issues with your plastic surgeon. Your surgeon
should be able to formulate a treatment plan that addresses your concerns.

Hi Belle Marie,You have a double fold on the left breast, as you described.    This line of flattening was probably your original breast fold.  I can't say for sure without preop photos.  You are still early enough to modify this with "bras and bands."  So keep your surgeon in the loop and get suggestions at your clinic.  To my eye your bottom edges of your breasts look equal, but hard to say without examining you. But that is good.  All the best, "Dr. Joe"

Sientra implants: healing after augmentationIt would appear from your info and photos that you may have some drop  out on the left side.i dont know how the doctor placed them or what you looked like before surgery.  taping and wearing an underwire can help..  check with your doctor

Hello and thank you for this question.  It appears from your pictures that you may have left breast implant displacement where the implant has stretched the tissues holding it up.  However, sometimes if one breast is slightly lower than the other before surgery, the surgeon may have placed the implant on that side lower to compensate.  It is more common for smooth than textured implants to drop although can happen with either.  Surgery will fix this issue.  Go see your surgeon to discuss this further.

Your observations are real - with a mound of breast tissue and implant not perfectly wed in smooth transition. I imagine you had a bit of breast tissue laxity or droop pre-op and more so on the left. Sometimes when an implant is placed low trying to compensate for this, or it settles more than expected (more common with smooth implants) a double bubble deformity can occur. You have a bit of this but it may settle out over the next few months. It's best to wait it all out to see the final results over the months to come. Nuances could be easily improved, more severe double bubble deformities may require resetting of the lower breast fold-implant pocket and/or lift mastopexy. Wait it out and see - and be happy and optimistic in the meantime. You can also use good bra support of the lower breast fold for the next few months as well. Waiting time is your ally in this process as the body heals and tissues relax and incorporate. 

I would agree with the other reviewers, I don't think this is bottoming out, and you may very well be looking at where an old crease or IMF was.  Regardless the shape and dimensions of your breasts look good, I suspect this may be a transient thing that passes as the remaining swelling resolves.  I would recommend you check in with your surgeon and review your preop pictures.  See if your surgeon recommends any special bra, at this point, while an in person exam would be necessary to know for sure, I doubt you will need any further surgery.  

The good news is that this problem will frequently improve on its own. It is usually by six months to one year when collagen remodeling takes place. The breast may soften and attenuate over the implant and the shapes join together to give a more uniform contour. This particular cause of contour irregularity in the bottom of the breast happens when the native breast sits atop the implant without reshaping.  Causes for this can be narrow based firm breasts prior to surgery.  Fibrocystic breast ( a common benign condition) can contribute.  But you are only two and a half months out from your procedure and more healing will take place.  If after adequate time has elapsed and you still don't see the results you want, other intervention may be necessary.  A small lift of the lower pole of the breast or revision of the augmentation can be performed.  Always convey to your plastic surgeon your feelings about the results.  He or she will often be your best bet to achieving the results you want. 

The implants are not bottoming out.  Your implants appear to be well placed, the surgeon probably had to lower your inframammary crease to center the implants and make sure the areola was centered, this does create a double-bubble, but this will stretch over time.

Congratulations on your result. It is even and looks to be a good size foe
you. I am sure you are happy. Where you have a "dent" is an area
of fibrous tissue on your breast and likely represents the old inframammary
fold or crease. You are only 2 plus
months out form your surgery and my experience is that this problem will settle
out and almost disappear. Usually by 6
months minor issues like this will almost go away and you will be even happier.


I hope that helps.

Best regards.