If I have mild tubular breasts & I were to receive a regular breast augmentation, would I develop double bubble deformity?

In your before photographs, your breasts were asymmetrical in volume, shape, position and lying low on the chest wall.  I would have initially recommended a breast lift.  However, the best way to eliminate double bubble is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices.  8% fail within the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Thank you for this in-depth question about tuberous (tubular) breasts.  I'm assuming the first picture you showed was, in fact, you.  Your picture is one of a classic Type II tuberous breast with constricted lower pole.  Your first surgery for augmentation of tuberous breasts show the classic misunderstanding of the uniqueness of tuberous breasts which always require a periareolar incision and release of constricted tissue.Transaxillary or inframammary incision of your type breasts routinely lead to a double bubble deformity, also known on lateral view as a Snoopy Nose deformity.  Release of the inferior constricted portion of your tuberous breast without placement of implant and/or tissue expander, in my opinion, is without merit.A secondary or redo surgery once you have a double bubble must release the constricted portion of your lower breast, to include muscle and fat, and should be from side to side.  Placement of a breast implant sizer during the surgery should tell the surgeon whether a double bubble will be evident in the post operative period.  An experienced surgeon will either place a tissue expander at this point or have the patient wear a tight bando for several weeks or more to force the implant to break down the double bubble.  Unfortunately, the problems you present are not unique.  The good news is there are many excellent Board Certified plastic surgeons experienced in the correction of tuberous breasts in Chicago.  Your job is to consult with several of them and choose the surgeon who seems right for you.

Hi, thank you for sharing your question. 
The ideal way to get
the best advice would be after an in person evaluation, however based
on your proposed scenario, I would say that a breast augmentation alone may only correct a mild tuberous breast deformity. If your situation is more advanced, you will require maneuvers to prevent a sub-optimal result an possible even a double bubble. 
Consult with a board certified plastic surgeon to review all your options. I hope this helps. Best of luck!

I am impressed by the scope of your research! Photos would be helpful because constricted or tuberous breast conditions can vary greatly.In extreme cases Tuberous Breasts, findings include breasts with narrow base diameter, herniated nipple areolar complexes, constricted lower pole Breast Tissue and high and tight inframammary folds. Only the severe cases demonstrate all of these findings. Double bubble deformity occurs when the inframammary fold needs to be lowered and the imprint of the old fold remains on the lower breast, above the new fold. Many tuberous breast corrections only require release of lower pole constricted breast tissue with placement of implants to maintain the breast shape and breast diameter and prevent the tissue from adhering again. The fold does not always need to be lowered and thus the risk of double bubble is eliminated. Consult with a board-certified plastic surgeon in your area with lots of experience with this syndrome to explore the best options for you. Good luck.

Dear Innovateandlearn,
tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall.The type of surgery best for you will depend on the severity of your condition.My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hi Innovateandlearn,
I'm sorry to hear you weren't happy with your initial results. Tuberous breasts can vary widely in presentation and in results depending on the experience and skill of your surgeon. You may have benefited from a periareolar placement of your implants as well as release of the lower pole constriction and a donut lift. Mistakes can be difficult to fix. It's hard to give advice without an in-person evaluation, but I would have a long detailed discussion with your surgeon before attempting another revision. Blessings on your journey!

Thank you for the question and your voluminous research but an examination is really needed.   So go on some complimentary consultations with experts and compare recommendations after a full examination and discussion of desired results then look at photos of similar patients and become fully informed about the desired procedure Dr Corbin

Hello. Thank you for your inquiry. It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually.

Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point.

There are many different factors that go into choosing a breast implant size which will correspond with your body dimensions while concurrently achieving your aesthetic results. Some of these factors are: Implant size (CC's), Implant profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants for the best results.

During a consultation your aesthetic goals are heard and taken into account with the measurements of your breasts and the integrity of your tissue, as well as level of ptosis (sag). From here we collectively can find your 'perfect fit'. You are able to try out sizers and different implants in our office such that you can get an idea of what size you would be post-operation. We also offer Crisalix 3D plastic surgery virtual simulator during our in-person and virtual consultations to preview potential results. After your consultation, you will receive your very own implant sizers to take home with you (at a small cost) whether or not you decide to go forward with your procedure.

I usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. I specialize in the 24-hour Recovery method which minimizes trauma to the breast and decreases pain post-operatively.

We encourage you to look at our website and Instagram (drkaraplasticsurgery) for lots of before and after pictures!
Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.

We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!

M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind
Hello. Thank you for your inquiry and congratulations on your surgery! It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.

Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery. We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!

M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

Tubular breast deformities are difficult problems to address, and the outcomes are very surgical technique dependent. It is possible to have a breast augmentation procedure without getting a double bubble deformity. In some surgeon's hands, it may require multiple staged surgery, while sometimes involving the need to use a tissue expander. At the same time, another surgeon might be able to achieve the desired results in either a single stage surgery or less stages. It all depends on your breast anatomy and shape as well as the surgeon you select. Having said that, it is possible to correct mild to moderate tubular breast deformities in a single stage, without getting a double bubble deformity. It is important to find a surgeon who is experienced in treating tubular breast deformity, and one who has the best approach for achieving the desired result in a single surgery, or the fewest number of surgeries possible.