I am four months post op from breast augmentation. I am able to feel the entire bottom of breast implant at the crease of my breasts. I am scared that way my breasts look I am either having the bottoming out effect or the double bubble effect. Is this an occurence in either complication?
Breast Augmentation Bottoming out or Double Bubble Effect?
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Being able to "feel" the implant at the inframammary crease level is normal especially in thin patients and especially with saline implants. This is not bottoming out or a double-bubble.
"Bottoming out" occurs when the implant descends below the crease and the breast loses its fullness in the upper pole as it settles into the lower pole. If you have a crease incision, you will see it riding up onto the lower pole of the breast.
A "double-bubble" occurs when the inframammary crease is lowered to form a new crease farther down and the old crease retains a memory and creates an indentation across the lower pole above where the new crease forms.
Both of these problems can be treated but sometimes they aren't easy to fix.
Breast Implant Bottoming Out Different from Double Bubble
Thank you for your question. Bottoming out refers to the Breast Implant dropping low under the breast and creating the appearance of the breast mound below the Nipple-the Nipple -Areola appears too high on the breast. With Bottoming Out of the Breast Implant however, the Inframammary Crease-the fold beneath your breast is intact.
The Double Bubble Breast Implant occurs when the Inframammary Crease is violated and the Breast Implant slides below the crease. This creates a second area of fullness below the crease on side view-a second bubble. The Inframammary Crease appears on top of this second bulge instead of below the breast as is the normal case.
See your Plastic Surgeon for an exam.
You would need to be examined
It's difficult to know without an examination, but both bottoming out or a double bubble can happen after breast augmentation. On the other hand, if you are thin and had saline breast implants, the edges of the implant can be felt (this can sometimes occur with silicone implants, although it's less common).
I would discuss your concerns with the surgeon who performed the procedure, and if needed, seek a second opinion with a Board Certified Plastic Surgeon in your region. If everything is ok, this will at least alleviate your concerns. If not, either problem can be improved, but depending on how severe the problem is, it may not be corrected completely.
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Are you bottoming out?
Large Implants due to their weight, gravity, thinning of tissues, chronically not wearing a bra, loss of elasticity and other factors may cause continued stretching so that your breast implant is no longer supported in its ideal position. This results in the progressive lowering of the inferior breast crease (inframammary fold). When the implant moves South to an undesired inferior position it results in the loss of volume and flattening of the upper pole of the breast, too much volume at the lower pole, increasing the distance from the fold to the nipple and finally the nipple position being abnormally high ( pointing up) and not centered. Similarly, the pocket can also stretch to the side (lateral) so that when lying down your implants fall towards your arm pits or sides, causing the “Side Boobs” appearance.
Bottoming out and Side Boobs Contributing Factors:
- Larger/Heavier Implants
- Implants placed above the pectoralis muscle
- Chronically not wearing a bra when upright
- Over dissection of the Implant Pocket
- Smooth Implants
- Large swings of weight including pregnancy
- Skin and soft tissue laxity, loss of elasticity
Implant position is important
Follow up with your surgeon
These complications have occured, however it is difficult to diagnosis without an examination. If you are unhappy with your results or if you feel something is wrong or does not look right, you need to contact your doctor. He will examine you and determine if either of these are happening or if you are a thin patient, you will be more likely to feel the implants more than other patients.
If you are unsure about your results dont hesistate to contact your doctor, it is best to address your concerns as soon as possible.
Bottoming out or double bubble?
Bottoming Out Following Breast Augmentation
Based on your description I suspect that the origin of your problem is poor soft tissue coverage of your breast implants. It’s not unusual to be able to feel breast implants, in patients who are thin and have minimal breast tissue. This can be especially noticeable at the level of the infra mammary fold when saline implants are used. For this reason, silicone implants in a sub muscular position are usually recommended in women, who have these characteristics.
When bottoming out and the double bubble phenomena occur, the implants can usually be felt below the level of the inframammary fold. When these problems occur, aggressive surgical reconstruction is necessary to correct them.
If you have concerns about palpable implants, discussion with your plastic surgeon is appropriate. Your surgeon should be able to make a correct diagnosis and formulate a proper treatment plan for you.