Is a double bubble the same as ptosis? What should I do to correct the damage? (photo)

I was given a HORRIBLE surgery by Dr. Goodkind in Branford CT and am desperately searching for a way to correct what he has done. Firstly- is a double bubble the same as ptosis? Secondly- what would be my best plan of action to correct this? I currently have saline, under muscle and was thinking of switching to silicone over muscle. I was a B cup prior to surgery. ANY answers are welcome!! I really appreciate your help

Doctor Answers 9

Double bubble versus Ptosis

A breast implant occupies a space under the breast gland.  If the gland is well distributed over the implant, it generally looks good.  If the breast droops off the implant (as it may have drooped off the chest wall prior to surgery), then this is termed ptosis or "snoopy deformity."  As most breasts age in the years post augmentation, there is usually some ptosis.  Early ptosis may be  minimized with either a mastopexy (scars, cost, risk) or forcing the implant into the "bag" of breast.  This works well as long as there is not too much "bag."  Double bubble is when there is dense breast tissue on top of the implant that looks like frosting on a cup cake.  This may be unavoidable, but may be minimized with a larger implant and gland release.  Sometimes a large implant can herniate under the breast and give a double bubble appearance as well.


Boise Plastic Surgeon
5.0 out of 5 stars 5 reviews

Double bubble

Thank you for your question and I'm sorry to hear about your experience.  Double bubble is not the same as ptosis.  Breast ptosis refers to breast sagging.  Double bubble is when there's the appearance of 2 mounds of tissue either from the implant migrating beyond the breast fold or the breast tissue hanging below the axis of the implant.  You appear to have constricted breasts with  a double bubble deformity.  There are several options for treatment.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck.

Zachary Farris, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 14 reviews

Correction of double bubble troubles depends on the cause

There are 2 causes of double bubble, which is what it appears that you have: First is if the implant moves below the natural bottom fold of the breast. This can occur when the breast is constricted (short nipple to fold distance) or a little bit saggy when trying to avoid to a lift. The second cause is related to animation deformity. This occurs because the muscle is detached in the dual-plane procedure, and the cut muscle then adheres to the scar capsule where it exerts traction. You can diagnose this if you see the crease pulling up when you flex your pectoral muscle. That can be corrected by converting to the split muscle plane or going above the muscle, but the muscle must be re-attached. More detailed information is necessary in order to determine which procedure will be best in your specific case.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 45 reviews

Double Bubble

No, double bubble is different than ptosis.  Ptosis is when you have "dropping" of the breasts.  You have a double-bubble where the implant has fallen below all of the breast tissue. 

I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with and who is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery.

Best wishes!

Dr. Desai
Harvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Double bubble

It appears that you have a double bubble which is a risk of submuscular breast augmentation.  This requires a revision to fix and there are many different techniques that are utilized to correct this.  Find a board certified plastic surgeon who does a lot of implant revisions.  Best wishes. 

Jules Walters, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 40 reviews

Double bubble vs ptosis

No, a double bubble and ptosis are different. Ptosis refers to the breast gland itself and the position of the gland and nipple in relation to the breast fold.  A double bubble refers to an implant falling below the inframammary fold.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

Treatment of a constricted breast is best accomplish with sub glandular placement of implants.

The clinical picture is incomplete but it looks as though there is some constriction of the breast that would not be released by a mastotomy with sub muscular placement of the breast implant. Part of a revision would include placement of silicone gel implants in a sub glandular position.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 31 reviews

Double bubble

Hello and thank you for the photo and question. Yes, based on this photo you have a double bubble deformity. It is a real risk for breast augmentation, and frankly this is something that every doctor faces at some point in his / her career. 

There are corrective measures that include: tightening of the capsule, reinforcing the bottom of the breast with a matrix tissue layer, and implant exchange to a textured implant. I would start with the textured implant exchange to a narrower implant with capsule tightening. For more extreme cases, the dermal matrix would be used. 

All surgery carries some risk and this is a good reminder to patients to carefully weight the risks / benefits of plastic surgery before making any decisions. 

Ptosis is different. That is when there is excess breast skin sagging below the implant. That is not what you have. 

Best to you. 

Bennett Yang, MD
Rockville Plastic Surgeon
4.9 out of 5 stars 10 reviews

Correcting double bubble.

I'm sorry your surgery did not go as you wished.  You have a double bubble.  Ptosis is when the nipple and areola sit below the level of the fold that is under your breast.  A double bubble results from placing an implant so it lies below the patients natural fold under the breast.  The first bubble is the outline of the implant and the second bubble is the breast tissue sitting on top of the implant.  A revision surgery would be needed to correct this so the breast tissue lies uniformly over the implant as a smooth cone.  Always see a board certified plastic surgeon.

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.