2-months Post-Op BA; Double Bubble Forming? (photo)

Unfortunately, it does appear that you may be developing a "double bubble".  You may try taping the area to see if it may flatten down.  Otherwise, you may need surgery in the future to correct this.  A breast lift may be indicated as well to achieve optimal results.  You should discuss this with your surgeon to see what he/she suggests.  I personally do not like performing revisional surgery on my patients until 6 months post op.

You do indeed have double bubble on your left side. It appears from your early post-op photos that you had a fair amount of ptosis pre-operatively, and that you and your surgeon made the decision to try augmentation without automatically going to a breast lift plus implants, which would have mandated more scars and cost (not to mention still having the potential for implant malposition as the healing process went forward). Allowing your implants to drop into position behind the breasts and "fill" the skin brassiere is a reasonable plan that works in a majority of cases . . . but not every one.

Once healing is complete in several months, assessment of both breasts and their relative implant positions will allow a precise surgical revision plan with a high likelihood of success. You may simply need capsulorrhaphy (tightening of the internal scar capsule with sutures) where the double bubble is evident, or perhaps more of a modified lift or even full lift, which is where many surgeons would have "automatically" gone in the first place.

Don't give up on the original plan yet; there is still a very reasonable likelihood that you can still have a very nice aesthetic result with a minimal revision. Follow your surgeon's advice and seek a second opinion from experienced ABPS-certified plastic surgeons only if what you hear doesn't seem to make sense. Best wishes! Dr. Tholen

can be an annoying issue for you but very common when starting with tuberous like breasts.  If you had that, your result is still quite good as you mention it not being an issue when dressed and only when you raise your arm.  There are ways to address that but my suggestion is to simply give it time as some of these smooth out adequately with time to where it no longer is an issue. 

It's great that you respect your plastic surgeon. That's usually a recipe for success!

It's hard for me to give you advice given no pre-op photo's.  It looks like you had a bit of a constriction of your lower pole on the left, which can also be called a "mild tuberous breast deformity." This is something we see more frequently than you would expect. The best advice I can give you is to be patient. Your breasts still need time to settle - this could possibly correct itself. Check in with your plastic surgeon through this process for reassurance. I would give it at least an additional 4 months before discussion of a revision. Needing a revision is always a possibility.

Again, it sounds like you are in good hands. 

Best of luck,

Jennifer Harrington MD

Yes you are forming a "double bubble" effect, the edge of the pectorals major muscle to the breast skin/fold. Fat grafts with riggotomies improves easily. 

 

 

To give you a more accurate and correct opinion of this  case I need to see preoperative photographs  to compare , but as I can see your breasts have  large  areola diameter and apparently little tissue in the lower pole, which is characteristic of a congenital breast  deformity known as tuberous breasts. This is a condition that has a high rate of recurrence, so its treatment is complex.  It is  required  further surgery to correct this problem.

In my humble opinion the best way to make the incision  is through  the periareolar route that  allows proper restructuring or reconstruction of breast tissue, the release of the flanges or fibrous bands in the lower pole and allows a reduction in  areola diameter to a  most aesthetic grade. I do not recommend any review until  6 months later.

Your photo does indeed show a double bubble where the implant does not fit within the breast envelope and the implant pocket sits below the natural breast fold.  The effect is as if the breast is sitting on top of the implant rather than the implant fitting within.  This can improve with a snug underwire to help define the lower pocket.  Revision might be necessary however most would suggest a wait is best.

Leah

It does appear that you may have a double bubble on the left side. This could be the original breast fold, or it could be an impression made by the lower edge of the pectoral muscle--easy to tell which in the office, not on this photo. (It would be helpful to have seen pre-op photos.)

Hard to say much more without a view of both breasts.

Regards.

If you are questioning whether you have developed a double bubble It does appear that you have. In my experience a second surgery will be required to correct this issue. It is not too early to consider this option.

After a breast augmentation the soft tissues of the breast stretch and often a double bubble which occurs because of a band at the level of the inframammary fold will spontaneously improve.

It is certainly worth waiting a minimum of six months and reassessing the situation then.

If the appearance of the lower pole of the breast hasn't smoothed out a revision that involves carefully weakening the soft tissues in the region of the internal band and perhaps repositioning the implant can be carried out.