Double bubble at 1 year post op? (Photo)

Question

I’m pretty sure I’ve developed what is called “double bubble”. Is this most likely the case and will it get worse with time? Could weight gain (nearly 10 pounds) have caused this? What can be done to correct this? Thank you in advance! First and only BA done Sept 2016 - 325cc hp round mentor implants below muscle

Donald R. Revis Jr, MD · Answer

Good morning!
You do indeed have some bottoming out with a double bubble on each side. It was not caused by your weight gain, and whether it will get worse over time really varies from patient to patient. Some patients develop a mild case like yours and it never changes. Other patients gradually worsen into a nagging, dull, heavy aching discomfort that can actually become real pain.This is the most common condition I treat.I
 recommend the Internal Bra, my strong permanent internal suturing technique which corrects your bottoming out and double bubble and
lifts and supports your implants over the long term- it is actually the 
most common revision I perform, about 5-6 times a week- it works and it 
lasts!I have attached a link to my Internal Bra / Breast Augmentation Revision photo gallery for your review- hope it helps!

Gary L. Ross, MBChB, FRCS · Answer

It does appear that the implant has dropped and causing the double bubble appearance. I would consult with your PS and run through the revisionary options available. This can be corrected and the key issue is how much it troubles you and whether it is getting worse - this will guide you towards the timing of a revision.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery. 
It looks like you have "double bubble" and breast implant bottoming appearance. A "double bubble" is a cosmetically undesirable circumstance for patients with breast implants, which occurs when the breast fails to take on the shape of the implant, resulting in the appearance of a visible line showing a separation between the bottom edge of the implant and the bottom edge of the natural breast.   Double bubble "deformities" may be more striking (visible) when breast implants have bottomed out.
 
There are several options when it comes to revisionary surgery to improve your outcome.  One option is to eliminate the pull of the pectorals major muscle either by completely releasing it or by suturing the muscle back down, thereby placing the breast implants  in the sub glandular position.  Patients who choose to have breast implants placed in the sub  glandular position should have enough breast tissue coverage to allow for this conversion. There are disadvantages of placing breast implants in the sub glandular position (such as increased risk of breast implant encapsulation) which should be considered as you make your decisions.
Another maneuver that may be helpful is raising the inframammary fold using capsulorraphy techniques. In my practice, this type of repair involves a two layer, permanent suture repair (reconstructing the inframammary fold areas). 
This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation.
Sometimes, depending on factors such as quality of skin along the lower breast poles, additional support provided by acellular dermal matrix or biosynthetic mesh may be very helpful. I have also found the use of acellular dermal matrix very helpful in cases where the skin/tissues are very thin and in cases of recurrent breast implant displacement. The acellular dermal matrix helps improve contour, improves irregularities caused by the underlying breast implant and/or scar tissue, and provides additional support ("sling" effect) for the breast implants.
 
Best wishes.

John W. Menard, MD · Answer

It does appear that the changes you demonstrate are consistent with a double bubble issue. In light of the fact that it has been a year, correction will probably require surgical intervention. I would discuss this with your surgeon and explore options.   Good luck.

Brooke R. Seckel, MD, FACS (retired) · Answer

I am sorry to hear of your difficulty following breast augmentation.  There does appear to be a double bubble on the left side.  This is caused by a low breast implant pocket and has nothing to do with weight loss or anything that you yourself did.  A surgical correction will be necessary.  To learn more please read below:

Double bubble at 1 year post op? (Photo)

Answers (5)

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