Indentation After Breast Augmentation

I had breast implants in June of 2008. It seems that I have an indentation under each breast. And it looks like my original smaller breast is just sitting on top and that they are not filled out completely. My plastic surgeon told me that this will fix itself, but it has been almost a year and it hasn't changed. Any suggestions?

Doctor Answers 10

Shape problems after breast augmentation

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Thanks for your question and I'm sorry to hear about your concerns after your breast augmentation.

In the vast majority of cases at 9 months after your surgery most of the swelling has resolved and your implants should have settled.

It sounds like you may have two issues, the first relates to your description of your breast tissue sitting on top of your implants. You may have constricted breast tissue that is not adapting to the shape of the implants. Most of the time this needs to be released for improvement 9 months out.

The indentations sound like they could be issues with the pocket where the implant sits.

You may need a revision to improve the shape.

I hope this helps.

Your breasts aren't going to change, get reevaluated

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I can understand your concern and the degree of disappointment that you are experiencing following your breast augmentation. The appearance of your breasts is not going to change for the better. At nine months, what you see is what you got.

There are several reasons that may cause a crease or indentation in the areas of each breast that you described. I would strongly advise you to return back to your plastic surgeon and discuss your issues with him one final time. If you are not convinced with his/her answers or you feel the need to seek another opinion, then make an appointment with a board certified/eligible plastic surgeon that experienced in breast surgery. I hope this helps!

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

Double bubble deformity

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What you're describing sounds like a classic double bubble deformity. This happens when the implants sit lower than the normal crease under the breast. This may be related to the original surgery or may have been caused by the implants "bottoming out" after surgery. This problem usually will not get better with time and will likely require revisional surgery to suture close the space beneath the original crease.

John Squires, MD
Denver Plastic Surgeon
4.9 out of 5 stars 82 reviews

Indentation under breast

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Unfortunately it is difficult to tell you what that is without seeing you, or photographs, or getting more info. Is it where the incision is? THen is may be soft tissue that separated from each other whent he pocket was closed. If it is palpability of the implant and an indent by that, it may difficult to correct.

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

Breast Revision is likely needed

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There could be many reasons for your condition, the facts are:

  1. A long period has passed since your surgery and things will not likely change.
  2. A revision will be needed.
  3. Pictures or a consultation with a board certified plastic surgeon will be needed. (I would start with your own surgeon).

Hope that helps!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

I am afraid what you have now is the final result.

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Hi! The good news is that you can almost certainly be made better with a revision. Try to find a surgeon who does a lot of revision breast augmentations. Ask to see before and after pictures.

It is very important to figure out exactly why you don't look right, and to have a precise surgical plan in advance.

Before the surgery is completed, the patient can be placed in the sitting position (you are still asleep, of course), and the surgeon can make sure that the size, shape, and symmetry are great. This takes the guess work out.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Breast indentations

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The appearance that you describe may be what is known as a "double bubble" deformity. It is a sometimes unfortunate consequence of breast augmentation surgery that can occur in the narrow based or tightly creased breast. Correcting the deformity would require a revisionary surgery, as you are now about 9 months out from your procedure and the appearance is not likely to change spontaneously from here. Return to your surgeon for a follow up evaluation and he/she can advise you on how to proceed to correction. Good luck!

I would wait for the year to be up

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This indentation is likely due to a fiberous band in the lower pole that is holding up the implant, and causing the indentation. I do not think that this is related to the capsule, but it could be.

Many times, if you are patient, and I know that it is a long time, it will settle on its own. If after a year it hasn't settled, you may need a secondary procedure to weaken the bands.

Constricted breast

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You have described your appearance well. As stated below, some physicians call this a double bubble while others call it bottoming out. It is interesting that it effected BOTH breasts.

Many people have strong attachements of the crease (underwire area) to the ribs while others have weak attachments. When the implant settles the natural cone, breast can look like it sits on the dome like implant. This can be worse in patients with a condition called constricted breasts. Given that you are about 9 months after surgery, it is unlikely that your breasts will change much at this point in time. Discuss your desires with your plastic surgeon and review your options.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Double Bubble?

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It sounds as if you may have a double bubble deformity. Of course that is difficult to assess without an examination. Typically you will have your final shape and position within 6mo of surgery. So there will not be much change for you regarding shape anymore. There are many things to consider such as was your implant place behind or in front of the muscle, does it sit too low or too high and does it appear that you may have developed two different folds under your breasts? These are the questions that you can go over with your surgeon. Sometimes a revision may address your concerns. Discuss a possible revision surgery with your surgeon and if it will correct what you are describing.

Bahram Ghaderi, MD
Chicago 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.