I had my surgery on June 24, 2011. What Are my Options to Correct Double Bubble?

Your breast width was much wider than distance between nipple and inframammary crease before surgery.  Because the implants are round (most of them), your surgeon needed to lower the inframammary crease, OR accept an artificially wide intermammary distance.  When the crease is lowered, there can be a visible junction between native breast tissue superficial to the implant and the subcutaneous implant just above the new inframammary fold.  To avoid this problem, we sometimes radially score the underside of mammary parenchyma facilitating redistribution of breast gland over the implant, but this technique has its limitations, and probably increases the incidence of capsular contracture by entering breast ducts that are colonized with commensal bacteria.  If you have round implants, consider replacement with Biodimensional elliptical implants (e.g. Allergan Style 410 low height full projection) or even Style 363 Saline.  At the time of your procedure, the lower pole should again be radially scored, and capsulorrhaphy performed along the inframammary crease as well.  Don't be upset at your surgeon.  He or she did the best possible job considering your pre-surgical presentation and the implants available.

Your identification of the problem is correct, in that you do have a moderate double bubble deformity. This issue aside, you do have a nice result from the breast augmentation surgery. Therefore, treatment should focus on what is good and correcting the lower poles. There are two reasonable options here: one would be to reinsert the correct position of the inframammary fold with sutures into a higher position and the second would be to remove a crescent of inframammary fold skin while reinserting the position of the fold to a higher point. In your case, the first option is more desirable. The timing is also good now that you have a well formed/healed breast capsule, allowing for placement of stronger sutures to repair the position. Option two is less likely to have problems and more certain to be successful in most hands, but there is te associated longer inframammary scar. As for your current scar, it is still immature and the color will most likely fade more as it matures. I hope this helps. Ramin Behmand