Switching from Smooth Implants to Textured for bottoming out/double bubble?

Went to my PS Dec 22nd b/c of bottoming out on b/l breasts. Animation distortion on the right when I flex my chest. My PS suggested this time replacing the implants from smooth to textured? Pretty sure I am going to schedule my surgery AGAIN! My surgery date will be Jan 14,2014. I am so nervous and really don't know what the right thing is to do! Original surg Mar 2013, Revision Oct 17 2013. Possible new surgery Jan 14 2014. Please help. Read my profile for further details.

Doctor Answers 8

Breast implants, double bubbles

Dear RN,
Perhaps you should have stated "see my profile for photos" and you would have received more meaningful responses.  From your very first pre operative photos, it appears that you really needed a lift with your augmentation.  Not performing a lift, for whatever reasons, i.e. you didn't want the scars, surgeon felt you didn't need one, may have been the causative factor for your current "double bubble" deformity.  The final set of photos following the revision in October do not depict the "double bubble" on the left side.  Has that side recurred as well?  Replacement of smooth implants with textured implants, in and of itself, is not a remedy for "double bubble" deformity, unless there is a plan to place them in a new plane above the muscle.  At any rate, you probably continue to need a lift.  Good luck!

Manhattan Plastic Surgeon
4.6 out of 5 stars 47 reviews

Double bubble.

Thank you for the question.

To best help you, I recommend a physical examination or picture evaluation in order to determine which procedure and technique would be the best one for your case. It´s very difficult to give a review with out any of these.

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 252 reviews

Bottoming out of my breast implants

Thanks for the question.  Bottoming out usually means that there is less breast tissue support for the implants in their current position.  This can be for many reasons, and the treatment may require several steps to fix.  Without  pictures I am unable to tell you precisely what should be done, but often times switching to textured implants and placing the implants into a new sub mammary pocket is usually to be considered.  Downsizing implants may also need to be considered.  On rare occasion material such as Alloderm to support the new breast implants may also have to be considered.

Please ask your Plastic Surgeon for suitable advice.

Good luck to you.

Frank Rieger M.D. Tampa Plastic Surgeon

No pictures to help

Sorry, but you story does not make sense without pictures. Some of the information does not seem correct. Please add more information and pictures! You may benefit from a new consultation with a reputable board certified plastic surgeon in your area. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 59 reviews

Double bubble

Unfortunately there are no photos to evaluate what the problem is.  That said from what you have relayed it appears your implants are submuscular as they distort when you flex.  Your surgeon maybe moving them to submammary and using a textured surfaced implant to decrease the incidence of capsular contracture in front of the muscle.  If he is keeping them behind the muscle and doing a capsuloraphy there is no benefit, in my judgment, to a textured implant.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Bottoming out, double bubble, and animation repair with split muscle technique

Very often the double bubble problem is related to animation, and when that is the case a capsule repair with or without textured implants may not reliably correct the problem. If you see pulling up at the groove across the bottom of the breast when you flex, then the cause is the muscle, not the original fold being lowered. Conversion to the split muscle technique preserves coverage over the upper part of the implant, where it is most important, while fixing the double bubble and animation. Bottoming out is fixed with a capsulorrhaphy. I would be happy to send you a copy of my article on this.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Bottoming out

It would be nice to see pictures to help evaluate your problem but typically switching from smooth to texture in a pocket that is already too big or too low does not typically make the pocket smaller or higher. A capsulorrhaphy is usually needed some times you will read about this being called an internal bra procedure but this is what is needed. It never hurts to get a second opinion before proceeding.

William J. Hedden, MD
Birmingham Plastic Surgeon
4.8 out of 5 stars 317 reviews

Smooth versus Textured Implants: Advantages of Textured Implants for Some Patients

Textured implants can be very useful for some patients in that they tend to sit higher in the breast pocket.  This is due to friction between the implant surface and the pocket lining.  It may be useful for patients whose smooth implants sit lower than desired.  On the other hand, texturing is not the classic way to repair double-bubble problems.  A capsulorrhapy procedure in which the pocket is tightened may be more useful.  Animation deformity can be improved with muscle modification.  These issues can be reviewed with your plastic surgeon.  The key to success is addressing each issue which you would like corrected.

Stephen Bresnick, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 32 reviews

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.