Breast Augmentation Revision for Double Bubble - Lift Question?

Hello! At my recent 6 month post-op, I had double bubble in my left breast due to the implant falling too low. My right is now the same. My PS said that I need a pocket repair and possible lift to correct ptosis (looks like my real tissue is sliding off). If he decides that a lift is necessary, my question is, will I lose any size at all? I don't want to go any smaller, at all, but I don't want my tissue to look as if it is sliding off either. I would go bigger but really doubt I can afford it.

Doctor Answers 7

Please send your pictures

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It is very hard to give you good answer without pictures. The surgery for the DB is not lift but pocket revision ,unless there were a need for lift and was ignored by the surgeon or refused by the patient.

New Orleans Plastic Surgeon
4.7 out of 5 stars 153 reviews

Double Bubble revision

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Breastlift for sagging breasts may decrease breast cup size, up to a cup size. It's important to consider the consequences - size, shape, scars - of going with a bigger implant vs. lift. Without photos it's hard to say. It sounds like you would benefit from a lift to center the nipple and breast tissue on the chest. Good luck!

Michele A. Shermak, MD
Baltimore Plastic Surgeon
4.8 out of 5 stars 57 reviews

Change in breast size from lift

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Two separate issues: in general, most breast lifts by themselves do not result in significant change in breast size as very little tissue is removed during the procedure. The elevation of the fold to correct the bottoming out is a separate issue and should also not change your size.  Both will change how your breast looks in a positive way.  Ask to see photos of actual patients.

Leonard T. Yu, MD
Maui Plastic Surgeon

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Breast Augmentation Revisionary Surgery for Double Bubble?

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Thank you for the question.

As you can imagine, it is not possible to give you precise advice without direct examination or,at least, viewing pictures. Based on the description of your “problem”, your plastic surgeon seems to be giving you reasonable advice. In other words, if a breast implant is displacing too low on the chest wall, internal suture repair (capsulorraphy) may be Indicated. It Is possible that further breast tissue and/or breast implant pocket manipulation will help improve the “interface” between the breast implant and your breast tissue ( to improve the appearance of the breast tissue “sliding off” the breast implant). Otherwise, some degree of breast lifting may be necessary.

 It is hard to say whether these manipulations will necessarily make your breasts look different in size.

 I would suggest that you communicate your goals further with your plastic surgeon. If still in doubt, additional in-person consultations (2nd opinions) may be helpful to you.

Best wishes.

Breast Augmentation Revision for Double Bubble Deformity?

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Double bubble deformity is when the breast implant falls below the fold of the breast. The breast fold will create a line across the implant giving the appearance of two separate bubbles, one above and one below the fold. This happened much more commonly when saline implants were used routinely. It is less common with silicone implants but still happens occasionally after breast augmentation. Patients can have the deformity on one breast or both sides.

Fortunately there is a treatment for a double bubble deformity and patients typically will get a good result after a revision. Patients usually have to wait about six months after the surgery for any revision. This time will allow a capsule to form around the breast implant. This capsule that forms around the implant can then be sutured closed to correct the pocket. This will raise the implant so that the implant no longer falls bellow the fold of the breast.

Occasionally if patients have a very week capsule or have had a failed revision previously they will need to have a mesh placed internally to support the implant and prevent the implant from falling overtime.
Patients also need to be careful and follow their surgeon’s post-operative instructions, as the repaired capsule needs time to heal. If patients are too active too fast in the post-operative period the repaired capsule may not have enough time to heal.

Please discuss your surgical options with a board certified plastic surgeon that has experience in revision breast surgery.

What You Need To Know About Double Bubble

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Double Bubble are the result of malposition of the implant and the implant cavity. Mismatch position of the breast tissue and the implants can also compound this problem. The correction will depend on how one plans to correct the deformity based on the position of the implant and where we want the position of the implant. It is best that you discuss with your board certified Plastic Surgeon so the best surgical plan can be decided together.

Colin Hong, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 40 reviews

Revision for double bubble based on cause

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Double bubble is an often misunderstood problem, and correcting it needs to be based on an understanding of what the cause in each specific case is. Importantly, if you have animation with it - meaning that when you flex your pectoral muscle you see pulling along the crease - then that has to be fixed in order for the double bubble repair to work. If it is caused by the implant dropping below the pre-exisiting bottom fold of the breast, then internal repair (capsulorrhaphy) along with an internal bra using Strattice or SERI Scaffold mesh would be sufficient.

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.