Double Bubble After Breast Enlargement - What Can Be Done?

What Can Be Done? Don't Want Smaller Implant.

Doctor Answers 3

Treating a double bubble after breast augmentation

A double bubble occurs after breast augmentation when the native breast tissue does not line up with the implant.  For an optimal result you want the nipples symmetric to the midline and about 20cm from the upper notch in the breast bone with the breast tissue and implant centered under the nipple. In some cases we allow some leeway in nipple position to minimize the amount of skin scarring. However the centering under the nipple of tissue and implant is sacrosanct. Many women do not have the breast tissue centered under the nipple before surgery and require some operative manipulation of the breast tissue just before putting the implant in. Hence the need for a proper evaluation before surgery, choosing a qualified surgeon and not picking your surgeon solely based on pricing with the idea that implant surgery is like gasoline (it's all the same). If the tissue center lies above the nipple and you center the implant on the nipple the lower edge of the implant will lie below the lower edge of the tissue. If the tissue is centered under the nipple but the surgeon disrupts the fold under the breast the implant will shift downward and again the lower edge of the implant will lie below the lower edge of the tissue. In such cases the visible double contour is called a double bubble.

The treatment for double bubble then depends on what maneuvers or lack of maneuvers caused the problem. If the fold was disrupted it has to be reconstructed. If the breast tissue center is too high the best option is barrel stave or radial cuts in the lower half of the breast tissue to allow it to settle downward a bit.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Treatment of "Double Bubble" after Breast Augmentation?

Thank you for the question.

Although best to give you advice after direct physical examination, patients who experience “double bubble” after breast augmentation may benefit from revision of the breast implant pockets (capsulorrhaphy and/or use of acellular dermal matrix).  Capsulorraphy  involves the use of permanent internal sutures to reconstruct the lower poles  of the breasts;  this procedure they help to improve the contour of this area.

Consultation with plastic surgeons well-versed with revision breast surgery may be helpful.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Implant Double Bubble,Toil and Trouble: Options for treatment of the Breast

There have been many different conditions called double bubble. This can occur with a constricted breast or tuberous breast and can be improved with radial relaxing incisions in the parenchyma. It can occur with bottioming out which can require a capsulorrhaphy possibly with the use of acellular dermal matrix. It can occur with capsular contracture which is treated with capsulectomy or neopectoral pocket and parenchymal redraping to the IMF. It can also occur with breast ptosis most commonly over a submuscular implant (also called a snoopy breast) which is best managed with a mastopexy and possible parenchymal reduction.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 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.