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Double Bubble or Implant Malposition?

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.

Doctor Answers (16)

Double Bubble or Implant Malposition?

+5

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. 

Miami Plastic Surgeon
4.5 out of 5 stars 56 reviews

Double bubble

+4

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!

Web reference: http://www.instituteplasticsurgery.com

Columbus Plastic Surgeon
5.0 out of 5 stars 6 reviews

Double bubble

+3

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.

Mobile Plastic Surgeon
4.0 out of 5 stars 6 reviews

Double bubble after augmentation

+3

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.  

Bellevue Plastic Surgeon
5.0 out of 5 stars 7 reviews

Implant malposition, breast implant revision

+3

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

Web reference: http://www.peterejohnsonmd.com

Chicago Plastic Surgeon
4.0 out of 5 stars 25 reviews

Double bubble and bottoming out often go together

+3

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 things typically do not improve on their own. Wish I had better news.

Seattle Plastic Surgeon
4.5 out of 5 stars 21 reviews

Double bubble after augmentation

+2

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.

Seattle Plastic Surgeon
5.0 out of 5 stars 44 reviews

Implant malposition

+1

Thank you for asking about your right breast implant position.

  1. The crease under the breast was fully released - so the breast implant has no support. Gravity pulled it down. 
  2. This is not an acceptable breast enlargement result.
  3. Your surgeon should correct this. If not, see another surgeon.
  4. I can often correct a disrupted mammary crease with local anesthesia in the office, but it is technically difficult. Many surgeons won't try it. Hope this helps. Best wishes.
Atlanta Plastic Surgeon
4.0 out of 5 stars 13 reviews

Double Bubble or Implant Malposition

+1

From the pictures it looks like you do have a double bubble deformity you will need an operation to fix it.

Web reference: http://www.drjsalomon.com/breast-augmentation-miami.asp

Miami Plastic Surgeon
4.5 out of 5 stars 35 reviews

Bottoming out?

+1

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 procedure reduces the size of the implant pocket and prevents the descent  of the implant on the right side. This procedure will improve the symmetry of the breasts  and the positioning of the nipple–areola on the left breast mound.
Make sure you're working with a well trained experienced board-certified plastic surgeon.  Capsulorrhaphy, even in the best of times, is not always successful in further revisionary surgery may be necessary.
Best wishes.

Web reference: http://www.poustiplasticsurgery.com/Procedures/procedure_breastrevision.htm

San Diego Plastic Surgeon
5.0 out of 5 stars 627 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.