Double Bubble? Can this be repaired without an implant exchange? (Photos)

Question

Post implant exchange. I’m 50 years old, 5’5” 118#, very little natural breast tissue, sub muscular placement before and with implant exchange. Original implants Sientra 435 HP, new implants 485 Natrelle. Left side looks perfectly normal He did have to stitch the lateral edge of the left pocket. I am thinking the same may have been needed on the right. Does this appear to be a double bubble and can it be repaired without another implant exchange?

Mehmet Ozdemir, MD · Answer

It is completely understandable to feel concerned when you notice an unevenness after surgery, especially since your left side healed so beautifully. Looking at your photos and history, this does appear to be a classic "double bubble" deformity on your right side. This happens because your new, larger Natrelle 485cc implants have a wider diameter and greater projection than your original Sientra 435cc ones, causing the right implant to sit lower and push past your natural inframammary fold (the crease under your breast), which splits your breast tissue into two distinct curves. The great news is that you absolutely do not need another implant exchange to fix this. A surgeon can correct it by performing an internal capsule repair called a capsulorrhaphy&mdash;essentially using internal, permanent sutures to elevate and securely redefine your natural breast crease from the inside, which lifts the implant back into its proper position and beautifully smooths out the double contour while keeping your current implants.

Daniel Barrett, MD · Answer

Dear Fierce568778,

though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Frank Agullo, MD · Answer

Your right side looks like a double bubble to me, but I am almost sure it can be fixed without removing or changing your 485 Natrelle. The left looks normal because the surgeon released the old inframammary fold band there and stitched the lateral edge of the pocket. On the right, he did not get that old fold band fully released, so it is now showing as a horizontal crease under the new fold.

To fix it, the surgeon takes down the old band through your original incision and does a capsulorrhaphy of the pocket, sometimes reinforced with GalaFlex Lite as an internal hammock to hold up the inferior pocket and prevent a future double fold. Your 485 Natrelle stays exactly where it is.

This is not an implant problem because there is no sign of bottoming out (where the projection point of the implant sits below your nipple). If both standing and supine exam confirm that on the right, capsule work alone is the play. No need to touch the actual implant.

#StayBeautiful,

@RealDrWorldWide

Double Bubble? Can this be repaired without an implant exchange? (Photos)

Answers (3)

More Breast Implant Revision Questions

Implant exchange - Would a narrower implant reduce lateral stress on the repaired capsule compared to the wider Xtra options?

6 years post breast aug - Did my implants rupture or just get bigger and sag? Will I need a lift or just new implants? (Photos)

Will moderate profile and pocket adjustment fix the strange shape of my breasts?

Keloid Scars After Breast Augmentation - Advice for Revision Surgery? (Photos)

Can revision from 265 cc subglandular to submuscular save me? (Capsule contraction, rippling, no cleavage, Rotation) (Photos)

Hard bands in breasts 1.5 years post op - what could cause this? (Photo)

WE SEND PRETTY
EMAILS