Bottoming out or normal anatomy? (Photos)

I'm 8 weeks PO and have asked my surgeon about this weird "underboob" that I discovered 3 weeks PO. I was told it was a normal anatomical complication, but I feel like it's getting worse. :( I'm just not convinced this is normal. I had 495cc silicone Sientra implants with a partial lift. Is it possible my implants are bottoming out? How can I fix this? Do I need a full lift? Thank you for your time!

Doctor Answers 4

Double-bubble deformity following breast implant surgery

Hi, unfortunately it looks as if you have developed a "double bubble" deformity, in which there is an extra "bubble" of tissue beneath the breast crease.  Although it's a little difficult to tell from the photos, it looks as if your breasts were initially fairly narrow, and that the fold had to be lowered to accommodate the implant.  In these cases, the old fold needs to be released a bit more to allow for a smooth contour of the lower pole of the breast.  I would ask your surgeon about addressing this, as this issue generally does not resolve on its own.  Best wishes.

New York Plastic Surgeon
4.3 out of 5 stars 6 reviews

Bottoming out or normal anatomy?

Thank you for sharing your question and photographs.  Unfortunately your current appearance is due either to bottoming out or your surgeon having lowered your breast crease with the old crease remaining prominent.  I would recommend waiting at least six months to assess your final result and then perform any necessary revisions - tightening the capsule or releasing the original breast crease tissue.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

Double bubble vs bottoming out

What the pictures show is a double bubble, likely due to the fold being lowered in order to accommodate the implant diameter. Sometimes this can worsen if you see animation, in other words the crease pulls up when you flex your pectoral muscle. In general, there are 3 things to consider: 

  • Raise the fold to its original location. If this is done then the lift would be converted to a vertical (lollipop) pattern in order to position the nipple high enough above the crease.
  • Raise the fold and change to an oval-base form-stable (gummy bear) implant.
  • Convert to the split muscle plane from the dual plane. This would be considered if the double bubble is related to animation.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

Pre-op photos would be helpful

in determining what problem you have... but your results suggest you had narrow based breasts that required lowering of your fold and what you see is your residual from your original fold.  Bottoming out is confirmed with a lengthening distance between your nipple and your fold... and you do not appear to be bottoming out right now.  So your 'normal anatomical complication' should have ideally been discussed with you so you would have anticipated it rather than thinking something is wrong... I'm sure your surgeon will learn from this and be more thorough during the consultation as we all learn from our experiences.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

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