Is this double bubble? What’s wrong with my nipple? (photos)

Your photos demonstrate what is called a "double bubble" . This is caused by the lower part of the breast contour being above the lower part of the implant. It is typically a problem of submuscular implants , certain breast shapes, and use of an implant too wide for a given breast with. A number of techniques exist to avoid or correct this, including releasing the breast tissue from the muscle and allowing it to redrape. Discuss your concerns with your surgeon.

Hi terriannexx,

Thank you for the question and the photo. I understand your concern.

Bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.

Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.

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.

If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Dear terriannexx, you're correct, you have a classical double bubble deformity.  Most commonly this deformity occurs when the implant bottom goes below your natural breast crease.  Unfortunately the only way to correct it is with surgery.  I really can't tell what's wrong with your nipple other than it appears swollen.  There's no reason for it to be swollen 22 weeks after surgery.  I'm curious to know the opinion of your surgeon regarding the double bubble.