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Double Bubble vs. Bottoming Out After Breast Implants

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Page Updated on May 31, 2022 by Dr. Norman Rowe (Plastic Surgeon) of Rowe Plastic Surgery

What Is a Double Bubble After Breast Implants?

A double bubble is a deformity that develops after a breast augmentation surgery. In a successful breast augmentation, the implants settle directly behind your breast tissue. Sometimes, though, the implants remain high on your chest wall or under the muscle. The breast tissue then settles lower than the implants. This complication requires a breast revision by an experienced cosmetic surgeon.

Breast augmentation using breast implants is a life-changing cosmetic procedure that millions of women take advantage of. With augmentation, you enjoy a larger breast size and an enhanced figure. Your new breasts also help you deal with self-image problems. While a breast implant is usually an effective breast enhancement procedure, the double bubble effect diminishes your results.

At Rowe Plastic Surgery in New Jersey, Manhattan, Long Island and the Hamptons, board certified plastic surgeons correct this double bubble deformity. This team of doctors working together delivers outstanding breast augmentation results. In addition to augmentation, the doctors perform:

What Is Bottoming Out After Breast Implants?

Bottoming out after a breast augmentation surgery refers to a complication in which an implant falls way below its initial placement. This deformity occurs if the breast skin and underlying tissue can’t support or hold the implant in its position.

After a breast augmentation with implants, you expect positive results, including fuller, shapelier breasts. Bottoming out ruins those expectations. Signs that your implants have bottomed out include:

  • Your nipples are pointing upward, which happens when the breast implant shifts downward.
  • You have a visible inframammary scar. After a successful breast augmentation, the inframammary scar isn’t obvious, as it’s hidden in the fold of your breast. If the scar has risen on your chest, it’s a sign of the bottoming out effect.
  • You feel discomfort or pain in your lower breast. When the implant slips down to your lower breast, you may experience pain and pressure in the area.
  • You notice the double bubble effect. This complication makes it seem like you have two breast mounds. This happens because the breast implants don’t settle properly.
  • You see a loss of upper breast volume. With the implants drooping to the lower part of the breast, the upper part suffers a loss of volume.

While bottoming out can occur because you have too little natural tissue and skin coverage, skilled placement of the implant also matters. At Rowe Plastic Surgery, a top New Jersey and New York City breast surgery facility, your plastic surgeon carries out a thorough assessment of your breasts and then develops an individualized surgical plan. This approach delivers better outcomes through more careful planning and placement of your breast implants.

What’s the Difference Between Double Bubble and Bottoming Out?

Double bubble and bottoming out are both complications of breast augmentation, but they’re not the same thing. The key differences that distinguish each include:

  • Double bubble refers to a situation where the breast tissue falls below the breast implants or your tissues push them up higher than they should be.
  • Bottoming out involves the implants sagging far below the natural inframammary crease.
  • Double bubble mostly occurs with large implants.
  • Double bubble can occur even if your breast enhancement didn’t include a breast lift.
  • Bottoming out mostly occurs because of poor structural support for the implants.

During your initial consultation, your breast surgeon at Rowe Plastic Surgery fields your questions about all the possible augmentation complications. Your doctor explains the approach to take to avoid double bubble and bottoming out. Experience and skill play a significant role in preventing these complications.

What Increases the Risks of Double Bubble After Breast Implants?

Situations that can cause or increase the risk of double bubble after you get breast implants include:

  • You have drooping, tuberous or asymmetrical breasts with your nipples pointing down below your inframammary crease.
  • A failure to combine a breast lift with your breast augmentation.
  • You have heavy breasts following a pregnancy that have fallen below the inframammary crease.
  • You chose very large implants, which are too heavy for your chest wall.
  • You developed a case of capsular contracture, in which excess scar tissue around the implant pocket pushed the implants down.
  • Your surgeon used the transaxillary approach to breast augmentation.

The best board certified cosmetic surgeon in NJ and NYC understands that these risks can cause a double bubble. With the correct precautions and applicable procedures done right, your breast surgeon avoids any complication and ensures your breasts retain a full beautiful appearance. You can trust the experts at Rowe Plastic Surgery.

What Are Some Risks of Bottoming Out After Breast Implants?

The factors and conditions that can cause bottoming out or increase the risk of the deformity after you get breast implants include:

  • The skin and underlying chest tissue can’t hold the breast implant in place.
  • You have little natural breast tissue or skin coverage.
  • You chose a large implant that’s too heavy for your tissue to support.
  • You have breast skin laxity caused by breastfeeding, aging, hormonal changes or weight loss.
  • You don’t wear adequate support for your implants after your breast augmentation surgery.
  • There’s not much of an internal scar formed on the lower part of your breasts.

Choosing the right cosmetic surgeon can prevent the double bubble and bottoming out deformities after you get breast implants. The team at Rowe Plastic Surgery have the experience, expertise and knowledge to carry out the most complex breast augmentation procedures safely and effectively.

How Can Breast Revision Surgery Help?

If you’re already suffering from one of these deformities after a breast implant procedure, breast revision is a surgical procedure where a cosmetic surgeon corrects the complications. Through the procedure, your surgeon:

  • Completely removes the implant
  • Replaces the implant with a smaller one
  • Adjusts the breast implant pocket for better results
  • Reestablishes the inframammary fold and prepares deep breast tissues to raise and support the implant to prevent bottoming out
  • Performs a mastopexy or breast lift to elevate the breast mound to prevent double bubble
  • Reconstructs the inframammary fold through a breast capsulorrhaphy procedure to prevent double bubble
  • Scores your breast parenchyma to better hold the implant in place

If you’re disappointed with your breast augmentation procedure, contact the team at Rowe Plastic Surgery in Red Bank or Montclair, NJ or in Manhattan, Plainview or Water Mill, NY. The team has experience in correcting double bubble, bottoming out and other complications after breast implants.


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