Breast Augmentation with Periareolar Lift - Possible Double Bubble? (photo)

I am not please with my left breast. It feels loose, slightly uncomfortable, heavy, looks lower, and you can see the natural breast over the implant. I cried to my surgeon and told him it didn't feel like it was in place compared to my right. He said everything is fine. My left doesn't fit well in my bras now, and Ben feels weird in a sports bra. He just told me to come back in six weeks. I woul like him to revise the left. Any advice? Can anyone tell me what it looks like? Am I crazy?

Doctor Answers 12

Double bubble on right

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It appears you have a double bubble on the right  - this is repaired with capsule sutures in most cases

Fixing Double Bubble

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   If your breasts had any element of constriction before, lowering of the fold may have been necessary.  Wait 6 months before any revision.  If the fold is raised the areola will appear lower, as you suggested, and may need an additional lift.

Breast Augmentation with Periareolar Lift - Possible Double Bubble?

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You have a double bubble  ( bottoming out ) of your right breast .This is causd by the implant being lower than the left and extending below the fold.

Correction is done by elevating the fold and fixating it in position

Hilton Becker, MD
Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

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Double Bubble?

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Yes, you have a double bubble deformity. It is easy to correct through the original augmentation scar but I would not want to do that for a minimum of three months after the surgery. The procedure is called a capsule repair.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

BA with Periareolar Lift - Can It Result in Double Bubble

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Your photos indicate that your breasts do look different, and it appears that you have a double  bubble situation on your left side (mirror photo). My guess is that you had a somewhat tubular shaped breast with a constricted base, underdeveloped lower pole, and a downward pointing nipple. This type of situation can be managed with the combination of procedures that were performed, and your right breast really looks quite nice. Unfortunately your left breast looks somewhat bottomed out and the implant position is too low. This is why it looks different in a bra. Your problem has nothing to do with the type of lift that was performed. It really has more to do with management of the breast tissue in the lower pole when placing the implant. Likely some lowering of the inframammary fold and repositioning of your breast tissue was required. However doing this increases the risk of implant malposition with the implant dropping below the level of your natural breast tissue result in the double bubble appearance. It likely can be corrected by repositioning your implant upwards along with some repositioning of the breast tissue so that it covers the lower portion of your implant. This problem will not improve with time and might possibly get worse. I believe that a revision is indicated, but remember that all surgical procedures carry some risk. 

Not happy with breasts

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I understand your concerns.  The appearance of the breast is due to the way your breast was before surgery, slightly tuberous on one side.  As you have read from the other surgeons, correcting it would involve a lift which requires scars.  Personally, I don't think the scars would be worth a little improvement in the shape of your breasts.  I agree with your surgeon. The result is not perfect, but no woman's breasts are, and there is always some degree of asymmetry.  Trying to correct your situation runs the risk of making things worse. Sorry, I know it is not the answer you wanted to hear, but I'm trying to keep you out of trouble.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 30 reviews

Double bubble

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The double bubble may have occurred because the breast is much narrower than the implant and sometimes with time it stretches out.  If the implant disrupted the fold, then a capsule procedure will need to be performed to resuspend it.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Peri-Areolar Double Bubble

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You are correct, you do have some double bubble effect with breast tissue falling over the implant.  This occured because a peri-areolar lift is not effective for lifting the is only effective for reducing or repositioning the areola.  A lollipop mastopexy would be more effective. A revision is indicated but you will require additional scarring. Good luck.

Correcting double bubble

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Correction of the double bubble can be achieved in multiple ways, including different lift techniques.

In my opinion, one of the most effective techniques of correction of the double bubble that does not require additional scars is fat transfer.  With fat transfer in the lower breast area, the implant is covered adequately and the transition from native breast tissue to the implant surface is corrected.

An important point is to differentiate between double bubble and bottomed out implants, which should be clear on physical examination by your PS. 

Mario Diana, MD
Plano Plastic Surgeon

How to fix double bubble breast implant problem

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First, I assume that the photo is taken from a mirror so that the problem breast appears on the right but is actually the left. The double bubble is defined by the curving indentation about halfway between the areola and the bottom of the breast. Often a predisposing factor to this is a tubular breast, in which case a vertical pattern lift may give a better shape. If not, then it would be very helpful to know if there is any animation deformity; in other words, do you see pulling upward along that line when you flex your pec? If that is the case, then conversion to a split muscle technique is an excellent way to correct the problem.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 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.