I am 3 months post op from having breast aug. I noticed the double bubble effect after 2 weeks post op. I have brought up my concern with my board certified surgeon at my last 2 visits, however he doesn't seem to be so concerned with this. My question is that do I have shell out another $6,500 to have them redone or will he cover the expenses? I was a c cup and he placed 700 cc saline in each breast. What questions should I ask him when I go back in May? I look ridiculous. Please help me
I Have Double Bubble, Do I Need to Pay to Fix This or Should my Surgeon Just Cover It? (photo)
Doctor Answers (7)
You developed a double bubble probably because the implants are too large for you and you also probably needed a lift.
Double bubble and revision costs
By not having the lift you needed (did you participate in that decision?) and by trying to place the implants as low as possible and by using big heavy implants, you were more at risk of a double bubble, which you seem to have. Revision (plus a lift) can be done but most doctors would do it for free with you paying something for the facility and anesthesia costs.
Revisions after surgery, who is "responsible"
Your photos are dark but there does appear to be a double bump under your breast. Revision policies will vary from practice to practice so it is important for you to know this as a part of preparing for surgery. You also may be considering a breast lift as a part of future surgery as well. I would recommend you continue to have discussion with your plastic surgeon about your concerns. I wish you well.
Web reference: http://www.medwardsmd.com/plasticsurgery_questions1.html
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Revising a Breast Double Bubble
From your photos, it appears that you probably needed a breast lift at the time of your breast augmentation. Hopefully after discussion with your surgeon, you both elected to have just an implant placed, and not a lift. Your problem is very correctable and will likely involved doing a breast lift, and not doing anything to interfere with your implants. Regarding who should pay for this, you need to discuss it with your surgeon. Most offices have (and all SHOULD have) a written revision policy that you sign prior to the surgery. Your surgeon will likely extend courtesy to you and charge you only the fees that he/she has no control over, such as the anesthesia and operating room fee. You should expect to have to pay something for the surgery though. You may also want a second opinion from another doctor, but a new doctor will likely charge you full amount for your revision, so best to stick with your original surgeon.
You clearly do have double bubble. I suspect it occurred because you have a degree of droopiness to your breasts and in order to avoid a lift your surgeon attempted to place the implants as low as possible. As a result a double bubble occurred. This should be quite fixable.
Your question is who is responsible for fixing it. In my opinion, the short answer is that both you and your surgeon should contribute. I feel your surgeon should operate without charging his professional fee, but I think you should pay for the operating room and anesthesia fees. This, I believe, is and should be the standard policy for plastic surgery practices.
There are some patients, however, that feel this is not justified. After all they feel that a bad result occurred, and this was due to a "mistake' made by the surgeon. Therefore, the surgeon should be responsible for fixing it in its entirety. I think it's important for patients to realize that surgery is not an exact science. It is not like other fields such as carpentry or flooring where exact measurements are made and therefore the end product should be as predicted. Medicine is different because we have the human body as part of the equation. This is where the unpredictability comes in. A surgeon can do the exact same operation on one patient and have a great result and yet, this same operation done exactly the same way on another patient can lead to poor results. Another words, a surgeon can do everything by the book, exactly how he or she was trained, and still the outcome can be less than desirable. We as plastic surgeons, and all doctors for that matter, do not as yet understand the human body in its entirety, but we are getting better. We can put a man on the moon, but yet we cannot cure the common cold. I think that patients have to realize that there is a level of unpredictability to plastic surgery and that there is a percentage of patients that need revision. All doctors have a revision rate. I know of some doctors that actually charge their professional fee for their revisions. I strongly disagree with them as well. I think a fair compromise is for the surgeon to give up their time and operate for free, and the patient to cover the other costs such as the operating room and anesthesia fees.
Ary Krau MD FACS
I Have Double Bubble, Do I Need to Pay to Fix This or Should my Surgeon Just Cover It?
Very difficult to give an answer because each surgeon has their own practice policies. Also better posting of your photos could be helpful. To me from "trying" to see the exposure on your posted photos yes you have the double bubble effect. The infra crease is released so you fall below it. I would recommend crease revision.
Photos are too dark and out of focus to confirm your diagnosis.
As far as the fix, each office will have its own policy, and you may well have it in writing in your pre-op packet. Most surgeons will charge at least on OR fee and anesthesia fee. Many will not charge a professional fee, or will reduce the fee.
The size of the implants is a known risk factor for double bubble, and for recurrence after repair, so think about whether you want to maintain that size.
Thank you for your question. Best wishes.
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.