Compound Problems After Breast Augmentation. Advise Please. (photo)

450cc gel implants placed under the muscle 10 weeks ago. Originally, I expressed concern that my left implant was too high, and my PS graciously offered to do a pocket revision @ n/c (haven't scheduled it yet). I'm also noticing a double bubble on my right breast. When I flex my peck muscles I can see a tight band across the implant. I mentioned my concerns about my right breast to my PS he didn't have much to say. What techniques would you plan for my upcoming revision to address both breasts?

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11 Doctor Answers | Asked by Emily555

Doctor Answers (11)
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Question about breast augmentation result

Actually, there might be no problem with the left side at all. The bottomed out implant needs to be fixed as this will not self-repair and in doing that and tacking the crease back down, it looks like your creases will be even again, the implant will be pushed up to look more like the left one, and the areola will be pulled down to be more level. Make sure the diagnosis is right as it might all be from the right side even though you thought it started on the left. more

Tuberous breast prop?

Your left breast is a little higher and that is not unusual early. I would give that more time, but you may need a release of the capsule on the left. Your right breast simply does not have enough tissue to cover the implant. It would not surprise me if you had a tuberous breast preoperatively. It is subtle and one option is to ignore it. I doubt other persons would ever notice it. The easiest way to fix that is to place the implants on top of the muscle. A... more

Breast Asymmetry

Hello Emily555, I am sorry that you are having problems after your breast augmentation surgery. You are 10 weeks out now , and I don't think that 'things might improve' if you wait longer. I also believe that you are getting close to a time where revision surgery would be appropriate. A true physical exam would be helpful in determining how much longer to wait. The underlying problem that caused these very different issues is one in the same: your... more

Double Bubble and High Implant after Breast Augmentation

Both double bubble and high implant are problems that can occur after breast augmentation. The first is due to not fully releasing the muscle medially. It is one of the reasons that I prefer to place the implants above the muscle if your tissues are such that it is possible. The high implant is due to not dissecting the pocket far enough inferiorly. Both are usually fairly simple to revise.

Double bubble after submuscular augmentation

Unfortunately this type of problem occurs when implants are placed under the muscle. Gel implants are so soft and natural that for almost all women an over the muscle approach is superior. When the implants are under the muscle the muscle separates the implant from the breast which leads to the double bubble contour. Usually this is a late development as the breasts droop with age and the implants stay high, held up by the muscle. In your case the deformity has... more

Your assessment is correct

You will need revision for both breast as you have noticed. Your right breast has double bubble and the nipple is pointing more to the side . The reason is too much muscle release. Your left implant is positioned too high or the muscle was not released enough. I would suggest revision of the both breast. Your before picture would be helpful.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Implant issues

The two breasts were most likely a bit different. You have to give a bit more time to heal. I would wait 4 months at the minimum. If there is sitill a lerge discrepancy, perhaps different impalnts can be placed to adjust the volume discrepancy. If you have a double bubble then procedures to adjust that can be done as well.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

When to revise breast augmentation

When the problem is a straight forward one an early revision can stop anxiety and allow you to get on with things. If your issue was with the higher implant only then certainly a release at the fold will bring the implant down. The band across the other breast with muscle flexion, and soft double fold may improve with time, or they might need to be addressed as well. If you can wait several months, you may have a better picture of what the breast will require. Best of luck,... more

Breast implant revision

I usually suggest waiting 3 to 4 months prior to any revision to allow your body to soften and mature the wounds. From your photos you may require a repair (plication) of the right lower pole with a possible release of the transverse band and/or scoring of the deep underside of the breast gland. Concomitantly, a release (capsulotomy) of the left inferior pole may also be needed.

Breast augmentation revision surgery for compound problems

Of course you understand that no one can advise you without seeing you personally, but here are a few useful things to know: First, I have found that double bubble and animation problems such as you describe are both related to the dual-plane technique for under muscle placement (happy to send you an article if you like.) So fixing the double bubble and the animation problem have a common solution, which is converting to what is called a split muscle plane (see link below.) I would agree... more