Im Afraid This Dent is the Start of a Double Bubble..please Help (photo)

im a little over one month post op from a breast augmentation..silicone with crease insicion under the muscle. ive noticed this small dent on right breast since i took the tape off my scars. i dont know if its the position im angled in but it seems like im starting to have a slight deformity appearance with my breast. am i in the early stages of double bubble or something else? if this looks like something is wrong can it be fixeD?

Doctor Answers 6

Do I Have A Double Bubble?

The good news is the pictures you show and the dent you pointed out in no way indicate a double bubble.  This dent may be from any of several causes, none of which lead to a double bubble. 

Most plastic surgeons close their incisions deeply with large dissolvable sutures.  One of them may have caught the underside of your skin (dermis).  This should go away with time, pressure from the implant, and dissolving of this dissolvable suture.  Early capsular contractures can also show up as a dent, but if your breast is soft, then this would not be a worry. 

Discuss your concerns with your plastic surgeon.  He or she may recommend the use of Accolate or another leukotrine receptor antagonist if capsular contracture is a concern.  Also, ultrasound therapy (the kind physical therapists use for sore muscles) can soften the breast or help release a suture which may be binding down your tissue causing the dent.  And finally, tincture of time may be the right answer here since no double bubble is forming.   

Early “Double Bubble” after Breast Augmentation?

Thank you for the question and pictures.

I do not see evidence of “early double bubble” in the pictures you have provided. I would suggest continued follow-up with your plastic surgeon, who after direct examination, can provide you with better advice and/or reassurance.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Dent or double bubble

The dent looks like tethering maybe from scar tissue, it does not look like a double bubble issue at least from the views you showed.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

What about this dent on my breast? (photo)

A "double bubble" deformity results when the breast implant as it is positioned on the chest extends beyond boundaries of the native breast, and both the edge(s) of the native breast over the implant and the implant over the chest are visible.  To evaluate whether or not you have one, oblique and/or profile views would help, but I do not see it in your submitted photos.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Dent is not the start of a double bubble

A double bubble from an oversize pocket extending under the breast fold is not preceeded by a dent. The dent in your photo is related to the closure of your incision, and with time it may smooth out.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Double bubble deforimties occur when the implant is malpositioned relative to your breast tissue

From your photos it appears that you have tenting of the soft tissues from the sutures closing your incision rather than a double bubble problem. 

A double bubble deformity occurs when a breast implant is placed under the muscle, and is high on your breast mound vs. your breast tissue.  i.e. the implant 'shows' up top like when your wear a push up bra, and your native tissue is sagging in front and below the visible edges of the implant.

You should ask your surgeon to be sure but you can probably just wait and allow the tissues to relax and the sutures to dissolve.  This may take some time so be patient.

Nikesh K. Patel, MD
Freehold Plastic Surgeon
5.0 out of 5 stars 17 reviews

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