This patient underwent bilateral capsulorraphies to correct the bottoming out by raising the implants which significantly improves the appearance of the breast.
Bottoming out is the term used to describe an implant that drops too low (also known as implant malposition or a "double bubble"). This complication gives the perception that the nipple is too high and can make clothes fit poorly. Many patients who have experienced bottoming out complain that their nipple is too high and will show out of the tops of bathing suits. This happens because the distance between the nipple and the bottom of the breast is too long and the nipple will ride up out of the top of the bathing suit.
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Correcting Bottoming Out
Bottoming out may be corrected by tightening and raising the fold. The fold is tightened and raised by making a small incision underneath the breast and placing sutures along the bottom of the breast to tighten the fold and reposition the implant back into the proper position which re-centers the nipple over the implant. This will significantly improve the appearance of the breast and clothes as well as bathing suits will fit much better.
This patient underwent a left breast capsulorrhaphy to correct the bottoming out by raising the implant which significantly improves the apparance of the breast.
A double bubble occurs when an implant drops too low or when the implant drops down behind the natural fold of the breast rather than forward into the breast. This creates 2 folds with an unnatural appearance to the breast.
Depending on the patient's breast, a double bubble may be corrected in 1 of 2 ways: either by tightening and raising the fold or with a breast lift (mastopexy). The fold is tightened and raised by making a small incision underneath the breast and placing sutures along the bottom of the breast to tighten the fold and reposition the implant back into the proper position. The other option is to perform a breast lift in which the skin of the breast is tightened. Your surgeon can further discuss which option may be best for you.
This patient underwent breast augmentation surgery several years prior by an outside surgeon and subsequently developed a double bubble on the right side (top photos). She underwent an implant exchange from saline to silicone and a right breast capsulorrhaphy to correct the double bubble (bottom photos).