Breast augmentation is a wonderful procedure that can restore shape, body proportion and confidence to any patient. But there are several long-term potential problems that can occur that must be recognized and treated. “Bottoming out” and the “double bubble” deformity are two of them.
When implants are initially placed they tend to “ride high” or sit more superior in relation to the breast tissue. With time and often with the help of a special bra they will descend over the course of 3-4 weeks finally settling directly behind the breast mound. Preventing the implants from dropping too low requires a few basics. First, the inframammary fold or the crease below the breast must not be violated when forming the implant pocket. Second, the deep tissues at the inframammary fold must be resutured to the chest wall fascia. If these two principles are adhered to than the implants will stay where they need to. However, if not than the implants can fall below the central mound of the breast creating more fullness below the nipple rather than behind it. Hence “bottoming out.”
The “double bubble” deformity is basically the opposite of “bottoming out.” In this case it’s the breast tissue that descends instead of the implant. This may occur with age, loss of weight or pregnancy. In this case the breast tissue falls and therefore the implant now gives more fullness in the superior part of the breast. Hence from the side one sees the convexity of the implant then the convexity of the breast below it. This is also called breast ptosis.
Correcting “bottoming out” requires reestablisment of the inframmanry fold and deeper breast tissues to move the implant superiorly. Correction of the “double bubble” requires a mastopexy to reelevate the breast mound.
If you’d like to talk about these issues or any cosmetic concern click here or call 703.752.6608 for a complementary consultation.
