Will Double Bubble Breast Implants Correct Themselves with Time?

I am 4 weeks post-op from a revision for bilateral grade IV capsular contracture, during which I went from 315cc saline HP unders to 350cc mod+ silicone with the same placement. The double bubble became visible within the first week and I've only noticed minimal improvement. While I'd be heartbroken if additional surgery is required, I don't want to wait things out with less than satisfactory results for too long. Should I give it past the 6 month mark to smooth out?

Doctor Answers 16

Double Bubble Breast Implants Require Surgical Revision

Thank you for your email. The Double Bubble Breast Implant deformity requires surgical reconstruction of the Inframammary Crease. However, 4-6 weeks is too early to have the surgery. Most Plastic Surgeons I know would wait 6 months to do the correction.

This correction can usually create a very nice result. Good luck

Too early to know, breast implant results may improve on their own

There can be a residual tight band of skin along the lower portion of the breast following your revision that is causing the double bubble appearance. Often times this will slowly stretch and improve during the first few months. At 4 weeks it is just too soon to tell. You really need to allow up to 6 months to see the final appearance. That would be the best time to look at the appearance and determine if anything more needs to be done. Hope this helps.

Robert B. Pollack, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 14 reviews

Double bubble

Dear Seashell

I think it is far too soon to tell. You are concerned so speak to your surgeon about your concerns. There are several causes of the double bubble including a crease that is lowered beyond the crease and also tuberous breast deformity. I certainly would not go in now as this is the worst time in terms of the healing process so be patient, talk to you surgeon and at least wait out the 3-6 months it takes to settle down.

Good luck

Steven Schuster, MD, FACS
Boca Raton Plastic Surgeon
4.0 out of 5 stars 8 reviews

Wait 3-6 months-- then revision may be necessary.

The double bubble phenomena can occur for a variety of reasons.In someone who has just undergone revisional breast surgery, it’s hard to know the exact cause of this problem without an operative report or physical examination.Depending upon the cause, the prognosis may vary widely.
In some cases, the weight of the implant may expand the persistent inframammary fold and this may eventually result in resolution of the problem.This may take upwards of three to six months to occur.
For this reason, it’s important to wait for three to six months before proceeding with revisional surgery.At this time, the situation has usually stabilized and an objective decision can be made.In most cases, correction will involve reconstruction of the inframammary fold.Some patients may require breast lift surgery, as well.
It’s important that you maintain contact with your plastic surgeon.Your surgeon should be able to evaluate the problem and formulate an appropriate treatment plan.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Will Double Bubble Breast Implants Correct Themselves with Time?

I am sorry to hear about the complication you have experienced. The double bubble phenomenon usually represents  a problem along the lower pole of the breasts,  where one can feel/see the breast implant below the “previous” infra mammary fold area. One “bubble” is caused by the breast implant, the other by the breast tissue.

Reconstruction will likely involve the use of sutures to repair the breast implant capsule and reconstruct the inframammary fold areas. The use of additional supporting material such as acellular dermal matrix or biosynthetic mesh may be helpful also.

Make sure that your plastic surgeon has significant/demonstrable experience helping patients with this type of revisionary breast surgery. You may find the attached link helpful to you as you learn more. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Double bubble breast deformity after implant placement

A double bubble deformity is the situation when the fullness of the implant is present superiorly and the mound of the natural breast appears to "fall off" the implant inferiorly, creating 2 areas of apparent breast, thus the "double bubble".   It can occur over time, for example, if an implant is placed when a breast is more youthful, the effects of aging, gravity, loss of elasticity, weight fluctuations, pregnancy and hormonal changes may allow for the natural breast to "fall off" the mound of the implant. The second scenario can happen during surgery, such as what has happened in this case:  the implants were placed too high, not at the level of the breast fold, giving the illusion of a "double bubble".  Some surgeons do this on purpose, and they expect gravity and the weight of the implants will cause descent of the implants.  Sometimes they will have their patient wear a garment, like a velcro strapped band placed above the breasts, in order to press the implants downward. The farther out from the surgery, the less likelihood there is that this descent will occur. There is not a "magic" time period that this will occur, but I would expect the surgeon to recommend waiting at least 3 months before suggesting surgical correction. If there is improvement during that time, it may be appropriate to wait up to the 6 month post op time frame, but certainly, if there is no improvement by that time, "tincture of time" will not be of benefit and surgery is the appropriate corrective measure.

Jana K. Rasmussen, MD
West Palm Beach Plastic Surgeon

Double bubble

Sometimes if you notice early signs of a double bubble, you can reinforce the fold and it will be better.  In general, double bubbles do  not improve.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Will Double Bubble Breast Implants Correct Themselves with Time?

Depending on the cause of the double bubble, in some instances such as tuberous breasts, I have seen improvement with time. But in the case of your descriiption, unless radial relaxing incsions were performed, it is difficult to prognosticate.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Evaluate a Double Bubble Months After Surgery

There are multiple reasons for a double bubble....

  • Inframammary crease too high relative to the implant
    • tuberous breast deformities
    • short distances between the areola and the fold
  • The implant too low relative to the crease
    • poor surgical positioning of the implant
    • implant too large for your chest wall
  • Residual scarring
    • incomplete capsulectomy
    • new scarring from the other surgery

Regardless, I don't call anything a double bubble until the tissues have settled and started to heal. It is far too early to make any conclusions. Return to your physician, mention your concerns, and develop a plan that is satisfactory to you both.

Michael C. Pickart, MD
Ventura Plastic Surgeon
5.0 out of 5 stars 5 reviews

Double bubble deformity

The double-bubble deformity occurs when your tissues try to stay in a different location from your infra-mammary fold. This may get a little better with time, but it is really too soon to tell if you'll need additional surgery since the tissue need to settle and your swelling needs to resolve. I would recommend speaking with your surgeon about your concerns. Capsular contracture is a very challenging problem for both the patient and surgeon, and I hope that you are at least more comfortable. All the best, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 14 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.