Small Area Under Breast? (photo

I'm wondering if I will not have any double bubble problems because the part under my areola is too small. Also my areola seems to big, is it going to look aesthetic? I'm 5'6" 144 lb cup b. I have hips, I'm afraid that I may look fat with bigger breasts. Thank you for your comments!

Doctor Answers 13

Constricted breast options

What you are describing and the photo you provided suggest you have a constricted breast where the inframammary fold is high and tight. Your left breast also has mild tuberous breast change with lower nipple areolar position and enlarged areola as well. It's important to think about your implant placement location, size of implant and shape/profile of implant. If you feel the areola is too large then consider reducing it during surgery. If you choose an implant that's too big and during dissection the fold is not lowered properly then you will run into the risk of double bubble deformity. It also appeared that your left breast is larger than right breast. Given this amount of asymmetry, you should meet with an experienced board certified plastic surgeon and get a detailed evaluation. Make sure you clearly state your goals and areas of concern so that the treatment plan will allow you to achieve your desired look.

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery 

Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Worried about Double-Bubble Deformity

The double bubble deformity only happens when the surgeon disrupts the natural anatomy of the lower crease. That isn't necessary for you unless you want an oversized implant. One good option is the Mentor Spectrum adjustable saline implant coupled with a small periareolar lift. That implant can be put in with a relatively small volume and gradually enlarged to generate more skin length in the lower breast as long as the lower part of the implant is not under the muscle. That would require a dual plane procedure which your surgeon will be able to explain to you.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Consider subfascial breast augmentation and purse-string areolaplasty


Thank you for the question and photos.  Depending on what you would like to achieve in terms of your overall results I think a subfascial breast augmentation with silicone implants and a purse-string areolaplasty would provide a great result for you. I have included a link from one of my patients before and after photos who had a similar procedure.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

Breast Implants Sizing

A short distance from the areola to the bottom of the breasts means that you either need a small implant; or a lift to reposition the nipple high enough on a larger breast. This way the implant can stay above the fold to avoid a "double bubble." If you are concerned about the size of your areola, a periareolar lift woud control the areola size and give some lift.In terms of looking fat, try the implants on in a bra, and look at 3d images of yourself with implant sizes to see what it will look like.

Michael Horn, MD
Chicago Plastic Surgeon
4.4 out of 5 stars 54 reviews

Double bubble/implants/breast lift

Hi,  My suggestion is to reduce the size of your areolas and do an augmentation.  By reducing the areola size and and doing an asymmetrical breast lift, then you will essentially increase the distance from the crease to the nipple complex.  Now the areolas are more centered and your augmentation will complete the "perkier" look.   This would not result in a double look whatsoever.  Good luck.  Make sure you consult with ps's who are board certified and do a great number of breast cases. 

Steven M. Lynch, MD
Albany Plastic Surgeon
5.0 out of 5 stars 18 reviews

Avoiding Double Bubble in Constricted Breast

   In most women with constricted breast I have found that they would prefer to have a rounder, larger breast.  Although routine lowering of the IMF is not for everyone, there is an art to lowering this and can be done without totally obliterating the region and causing double bubble.  As a conservative estimate, I treated about 100 women last year with significant constriction, tubular, or tuberous breast deformity, and I have not had a double bubble in followup.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Options to correct a constricted breast shape in breast augentation

From observing your photograph it appears that you have several challenges to obtain an aesthetically pleasing breast.  All of these can be accounted for to help you achieve your best result.  You do have a high and tight inframammary crease which is causing you to have a constricted breast shape.  The areola on the left side is lower than the right and also larger in diameter.  Implant placement and pocket dissection are critical.   In most cases similar to yours the inframammary crease will need to be lowered.  It is important that the center of the implant is directly behind the center of the implant, if it is too low then the breast will have a bottomed out appearance, if it is placed too high then it will force the nipple to point down.   The constricted portion of the breast can be incised from the inside to allow the breast to splay out over the implant. In order to achieve symmetry you may want to consider a peri-areolar lift or areolar reduction, most likely on both sides.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Double Bubble Concerns

Dear Mosa,

Thank you for sharing you photo.

I can understand why are concerned with the double bubble. 

However, with the right skilled surgeon carefully planning and performing your surgery the risks of developing a double bubble effect will be diminished.

At this point, a reasonable sized implant will be a good consideration therefore decreasing your risk of having the anatomical integrity of your lower fold.

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 195 reviews

Proportion and breast surgery

You have several options available to you.  You could chose to have a augmentation alone or have an augmentation and also have a nipple reduction and small lift done on the left side to raise it into a position equal to the opposite side. 

If you pick an appropriate size implant it should create an appealing proportion with hour hips rather than make you look heavy.

Good luck with your decision,

 Doug Hargrave M.D.

Douglas Hargrave, MD
Albany Plastic Surgeon
5.0 out of 5 stars 23 reviews

Small Area Under Breast?

Eve with the poor exposed photo you have an issue that needs surgery revision to correct. Seek in person second opinions. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 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.