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Double Bubble or Implant Malposition?

asked 1 year ago by Kay Girl in oregon
Latest answer by Tom J. Pousti, MD
Question viewed 1,002 times
Tags: 150-169 lbs, 5 ft 8 in to 6 ft 0 in, saline implants, 450-499cc, double bubble, position

Photo one week post op. IMF were lowered to make nipple placement correct. Saline 425 filled to 460cc. I'm 5'10, 150lbs. My left breast was a little larger due to the presence of milk. I was 2 months out from nursing on left side 4 months out on the right (it had stopped producing milk). What is going on and is it going to resolve? My PS said that everything looks great, but there is an obvious concern considering what my right "girl" looks like its to low and creating a double bubbl.

14 answers to Double Bubble or Implant Malposition?

Double Bubble or Implant Malposition?

The posted photos are of help. The right "girl" has had a overly dissected inframammary fold release. This is not the double bubble but more poor attention to detail by the operative surgeon. You will need a repair. Sorry for your issues.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Double bubble

You indeed have what is called a double bubble deformity on the right. Since you are only one week out I would wear a bra that can compress the double bubble on the right and hold the implant up. It may not fix the problem and you would then need another operation. However it might work since you are so early after surgery and could help prevent having to have another surgery.

Randy Proffitt, MD
Mobile Plastic Surgeon

Double bubble

You do have a problem with your implant position and the right fold. This can be corrected with surgery to re-establish the fold. Good luck!

Bivik Rajnikant Shah, MD
Columbus Plastic Surgeon

Double bubble after augmentation

Thank you for the photos. Your preop photo shows that your breast crease on the left is lower than on the right. Unfortunately, your surgeon overdisected the fold on the right, causing your implant to drop, leaving you relatively empty superiorly as seen on your postop photo. You do have a double bubble and a lower right crease which is only correctable by surgery. Would wait at least 4 months.

George Marosan, MD
Bellevue Plastic Surgeon

www.bellevueplasticsurgeons.com

Implant malposition, breast implant revision

It seems clear from your photo that the right implant is below the breast fold and you may notice as it is probably difficult to keep the bra under the implant on the right side. You can call it a double bubble, or malposition, though in any case the pocket will need revision and repair. Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon

Double bubble and bottoming out often go together

The 2 conditions are often related and the repair can be more complicated than it appears. It isn't the terminology that is important, it is understanding all of the causes, which include the muscle release that is a routine part of the typical technique for under muscle placement. (In general, bottoming out usually refers to settling of the implant over time, but with double bubble the bottom edge of the breast appears too low.) As I said yesterday in reply to your earlier post, these... more

Richard Baxter, MD
Seattle Plastic Surgeon

Double bubble after augmentation

You do have a double bubble from over lowering the crease. It will need most likely revision after you have healed for 3-4 months unfortunately. I can say that your situation is why I personally rarely lower the crease and would rather raise (lift) the breast to position the breast properly over the implant. Your natural IM crease is the best barrier to implant descent and yours was lost in the surgery.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

www.randcosmeticsurgery.com

Bottoming out?

Yes I do think you have a problem with the implant position on the right side. It is likely that revision surgery will be necessary to improve the situation. I would suggest repair of the right inferior breast capsule with permanent internal sutures (capsulorrhaphy). This involves removal of a segment of breast implant capsule among the inferior/lower aspect of the breast implant pocket. The 2 edges of capsule tissue are sutured to one another with permanent suture. This... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

www.poustiplasticsurgery.com

Early Implant Malposition after breast aug.

The pictures you provided are very helpful. Unfortunately, it appears that your right inframammary fold was lowered too aggressively. The right implant has descended too far. Once the fold is released, it is difficult to control its position. This can lead to implant malposition and asymmetry. I would recommend wearing a very supportive bra to try to force the right implant upwards. However, you are most likely going to need a second surgery to elevate the right... more

Laurence Weider, MD
Dallas Plastic Surgeon

Breast implant malposition/double-bubble

There are two types of double-bubble deformity. One is when the inframammary crease and the implant are at the proper level but there is inadequate release of the lower edge of the pectoralis muscle and it pulls on the lower breast and is transmitted to the skin. The other is when the inframammary crease level stretches or descends and the implant becomes malpositioned too low relative to the breast. Sometimes both can occur at the same time. Your situation appears to be the second type... more

Scott L. Replogle, MD
Denver Plastic Surgeon

Early implant malposition after breast augmentation

You're pictures are very helpful in answering this question. It does appear that the right breast implant has dropped too far due to a too aggressive attempt at lowering the fold. When that natural fold is disrupted, the breast implant can drop below your breast leading to a "double bubble" deformity. Unfortunately, this deformity can usually only be improved with another surgery. This second surgery should probably be delayed at least three months... more

Naveen Setty, MD
Plano Plastic Surgeon

Double Bubble or Implant Malposition?

Double bubble deformity is a condition we see after breast augmentation where the actual breast tissue has not expanded over the implant and looks like one breast is sitting on the other breast and it gives a double bubble appearance. We usually see that in a condition called tubular breast where the lower pole of the breast doesn’t expand as much. Implant malposition is another situation and the implant can be too low or too high, in this case it looks like the implant is too low and... more

S. Ozan Sozer, MD
El Paso Plastic Surgeon

Implant malposition in the post-op period sometimes needs surgery

It appears that your right infra-mammary fold was disrupted during your breast augmentation, allowing the breast implant to drift below this important anatomic landmark. This problem does not improve with time and needs to be addressed by reconstructing the fold. This procedure can be done with suturing technique, or with the use of acellular dermal mastrix products like Strattice.

Scott Sattler, MD
Bellevue Plastic Surgeon

Double Bubble

Sorry to say that you do have a double bubble. This is because of aggressive dissection of the IMF and the fact that you have implants that are too big for your existing anatomy. You probably also needed a small circumareolar mastopexy to help accommodate the larger size implant without having to over dissect the inframammary fold on the right side. I also do not like the left side even though there does not seem to be a double bubble there. Good luck and sorry for... more