What are reasons for or causes of double bubble?

What are reasons for or causes of double bubble??

Doctor Answers 7

Double bubble causes

A double crease along the underside of the breast is what is usually known as double bubble.  It occurs when the lower edge of the implant is below the skin crease at the lower edge of the natural breast.  There are two main reasons for this: The skin crease is too high or the implant is too low.  
Constricted, tubular, or tuberous breast shape is when the natural skin crease is too high, and in more severe forms, too narrow.  If the lower edge of the implant is lined up with the natural crease, it would be too high relative to the nipples and the rib cage.  In this case, the crease must be lowered and/or widened to properly place the implant.  Sometimes, soft tissue releases such as radial scoring are used to help open up the narrow base of the natural breast and allow the crease to come down.  The natural tissues sometimes don't cooperate fully, and a remnant of the old crease is still visible.  This usually improves over time as the tissues stretch and the implant settles, but it is not always perfect.  In severe cases of tuberous breasts, the edges of the tight, narrow mound of natural breast tissue can be visible all the way around over the softer curve of the implant, but usually it is only a visible problem in the lower poles of the breasts.  Because of this, severely tuberous breasts are a major challenge in breast augmentation.
When the implant is too low, it can sit with its lower edge below a normally positioned skin crease.  It could be caused by overly large and heavy implants, poor tissue strength, a variant shape of the rib cage, or poor surgical technique.  It does not get better with time, and requires surgery to correct it, often using biomesh (such as Strattice or Alloderm) to reinforce the bottom of the implant pocket.

Spokane Plastic Surgeon
5.0 out of 5 stars 19 reviews

Double Bubble breast implant revisionary surgery #plasticsurgery

A double bubble deformity results when the breast infra-mammary fold and breast implant are not even in relation to each other - typically, the breast implant sits in a position lower than the infra-mammary fold. This is difficult issue to fix and typically requires Strattice scaffolding or other reconstructive techniques for a long term repair.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Double bubble

There are multiple causes of the double bible including too large an implant size, over dissection  of the breast crease, a high inframamary crease, and he omission of stabilizing fixation sutures to name a few. See a BCPS for your care. 
Good luck 

Carlos Burnett, MD, FACS
Westfield Plastic Surgeon
4.9 out of 5 stars 37 reviews

Double bubble

Hello, a double bubble is caused by a visible contour of the breast implant under the breast, that is separate from the normal curvature of the breast.  Sometimes this can be due to the implant dropping below the normal lower border of the breast, or due to constricting tissue within the breast itself.  Your surgeon will be able to provide a proper assessment and recommendations.

William Andrade, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 62 reviews

Double Bubble

Double bubble specifically happens when an implant drops down behind the natural fold (inframammary crease) where the lower breast connects to the chest - rather than forward into the chest. The shifting creates an unnatural indentation across the lower pole of the breast. This occurs mostly in women with sagging breasts who chose under the muscle implants. The tissue hangs low enough to create one set of folds, while the recently placed implants creates another fold. Women at risk have a small amount of skin between the bottom of their areola and the breast crease.It can also occur with:
  • Chosen implant being too big or heavy for the supporting tissues causing them to stretch sometimes beneath the inframammary crease.
  • Poorly positioned implants
  • Tuberous breasts

Jaime Perez, MD
Tampa Plastic Surgeon
4.8 out of 5 stars 75 reviews

Double Bubble

A double bubble deformity describes seeing a separate bulge or rounded area under the lower breast fold. This can be related to a band of tension remaining where a previous breast crease was- typically something that stretches out and resolves over time, or it can be related to a bottomed out implant and compromised breast fold. You must have your Plastic Surgeon assess you in person to determine if you have an issue requiring correction or not.
All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Double bubble

A double bubble implies that you're seeing two distinct contours, one caused by the old infra-mammary crease and the other by the bottom of the newly placed breast implant. The main reason that this happens, in my opinion, is that the base width of the implant exceeded the width that was available under maximum stretch in the preoperative breast. Some attempt then has been made to lower the infra-mammary crease. If the natural infra-mammary crease is separated at the level of skin, and the implant is in a different plane below the muscle this will cause a double contour to be seen. Hope this is helpful.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 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.