Double Bubble - could it be muscle attached to the scar? (Photos)

Dear a9arose,

though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Sometimes a double bubble situation can be a very complicated. It is hard to give you any usable advice without a good examination. The photographs you have taken are not from a good angle to assess a double bubble. Double bubbles have a variety of causes which are usually fixable with revision surgery. It seems you should go with your intuition on deciding whether to see a second opinion plastic surgeon. Good luck with things.

This photo is not sufficient for any meaningful comment and suggestion, unfortunately. However, it may be that postoperative scar attachment is creating breast deformity? A series of better photos or in-person evaluation would help. Good luck.

Thanks for your question, history and photo. Based on your description (your photos are limited) it does not sound as though your concerns can be addressed “in the office”, but more than likely require revision surgery.

Please consult with an experienced board certified plastic surgeon who can advise you. As a rule, double bubble deformities can vary, but either your description of the dual plane (under the muscle) implant position, it sounds like your double bubble deformity is related to muscle activation and this suggests that your implants may be best re-positioned above the muscle.

Again, a second opinion with an experience plastic surgeon would be your best next bet. Best of luck to you.

From the submitted photo and description it could be that the issue is as your surgeon advised. However without an exam and more information it's difficult to say for sure. It seems your surgeon is willing to work with you to address the concerns and he has had the benefit of evaluating you in person.

Just based on your one photo, it could well be due to scar tissue, and hopefully this can be released in the office.