Double-bubble and bottoming out are two common complications of breast augmentation surgery, but they're not the same.
What exactly are these complications and how do they differ? Let's break it down.
Dr Hertess is a Specialist Plastic Surgeon with a keen interest in breast surgery complications and corrective breast surgery. She explains the nuances between double-bubble and bottoming out.
What are "Double Bubble Breast Implants" and "Bottoming Out"?
Both of these are complications that affect the contour of the breast after implant surgery. However, they result from different issues and occur in different ways on the breast.
Double Bubble
Image 1: Left double bubble correction. Implants used were Mentor Smooth Round Moderate Plus Profile 375cc. Real patient of Dr Hertess Specialist Plastic Surgeon.
A "double bubble" appears as two folds or an implant 'shadow' on the breast.
Double Bubble Breast Cause:
Double bubble breast implant deformity occurs when the old breast fold re-emerges after surgery. This is usually caused by an implant that is too big or wide for the breast fold. Otherwise, a double bubble can occur when a tuberous breast has been augmented.
Symptoms:
- A more visible crease over the breast above the fold
- Slight bulge at breast base
Bottoming Out
Image 2: Bottoming out of left breast implant. Corrected with removal and replacement of breast implants. Replacement implants were Eurosil 400cc. Black dotted lines used to demonstrate correction of bottom out. Real patient of Dr Hertess Specialist Plastic Surgeon.
On the other hand, this complication appears as an implant in a lower position on the chest wall.
This happens when the implant slips below the natural breast crease, generally due to inadequate support or an implant that is too big or heavy for the tissue to support.
Symptoms:
- Low displacement of the implant below the fold
Double Bubble Treatment Options
Both these complications are primarily treated surgically.
In the case of a double bubble, the solution often involves reducing the size and width of the implant or releasing the original breast fold. A double bubble may also be fixed without changing the implant by releasing of the fold and fat grafting.
On the other hand, a bottom out can be resolved by revising the breast pocket and tightening the fold, using scar tissue or an internal bra to strengthen the tissue.
"This isn't always successful. The correct treatment is to downsize the implant and reduce its width and the projection," says Dr Hertess.
This is called breast implant replacement surgery.
Prevention of Double Bubble
To prevent the occurrence of the double bubble deformity, accurate measurement of the breast base is essential before breast augmentation surgery. The size of the implant chosen should closely match the measured breast base. If tuberous breasts are being augmented, then fat grafting at the time of augmentation surgery will address the double bubble deformity.
A perfect implant dimension ensures that the implant fits well within the natural contours of the breast, reducing the chances of the original breast fold re-emerging post-surgery.
At Dr Hertess Plastic Surgery, all breast implant sizes are carefully chosen using 3D imaging technology to reduce the risk of a double bubble implant complication.
Breast Fold Malposition FAQs
What causes a double bubble in breast implants?
A double bubble can be caused by an implant that is too large or wide for the breast fold, resulting in the original breast crease re-emerging after surgery. It may also be that the breast is tuberous prior to surgery.
How common is a double bubble?
According to the Aesthetic Plastic Surgery Journal, double bubble and bottoming-out are the second most common reasons for revision surgery after breast augmentation.
Can double bubble correct itself?
No, a double bubble cannot correct itself. Surgical intervention is necessary to correct this complication.
Can bottoming out fix itself?
No, bottoming out cannot fix itself and requires surgical intervention to correct it.
Expert Diagnosis and Correction
Dr Hertess is an expert in diagnosing and correcting these complications. With a deep understanding of the nuances of breast augmentation procedures, Dr Hertess can provide an accurate diagnosis and correct treatment plan to rectify these issues.
Dr Hertess will be able to assist you with the best-suited treatment options based on your unique case. Get in touch to discuss your options regarding double bubble breast implant problems, or any other breast complication.
Dr Hertess (MED0001372020) Registered Medical Practitioner, Specialist Plastic Surgeon (Specialist Registration in Surgery - Plastic Surgery).
