Double Bubble or Bottoming Out? Will this need a revision? (Photos)

You have a double bubble on the right side. You truly need to see a breast revision expert certified by the American Board of Plastic Surgery. Your revisionary surgeon will likely include extensive breast pocket work on the right to correct the fold malposition and likely use of internal support (i.e. Galaflex).

There are two causes of double bubble and sometimes they are both involved. The first is when the original crease of the bottom edge of the breast (inframammary fold or IMF) has to be lowered in order to accommodate the diameter of the implant. That is corrected with internal sutures called a capsulorrhaphy. The second cause relates to animation deformity from detachment of the muscle as part of dual plane placement. The edge of the muscle adheres to the capsule, causing a crease that looks like double bubble. If the crease pulls up when you flex your pec, then that is the cause. It is corrected by converting to either split muscle or subfascial with muscle reattachment.

In your before photograph, your breasts were asymmetrical in volume and position. Asymmetry is one of the hardest things to correct surgically. At this time, you have the double bubble look and this results from one fold being the new inframammary fold and the other being the original inframammary fold. You may need a revision, if it is bothering you that much.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. I have been in practice for over 30 years, and breast revision surgery is a large portion of my practice. You definitely have a double bubble. Most likely this occurs when a surgeon is trying to prevent you from having to have a lift and lowers the implant pocket to low as well as disrupting the breast inframammary crease ligament. I fixed this many times. You would need an internal bra-capsulorrhaphy, as well as a breast lift. You should have be able to have excellent and beautiful breast. Best wishes to you.