Do you think this is double bubble? (Photo)
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Doctor Answers 9
Thank you for your question. In looking at your before photos you did not have much tissue in the lower portion of your breast- this is known as constricted breast. The indent you are seeing is more than likely the bottom of your original breast with the implant seen underneath (commonly known as double bubble). It is possible that this will get better as your tissue stretches to accomodate the implant over the next three to six months. If it is not to your liking at that time your inframammary fold can be repositioned to the original fold height to eliminate this- keep in mind that your implants will sit higher and your nipples will look low. As to the worsening of the fold with chest flexion- this is known as animation deformity and occurs when the implant is placed beneath the muscle. The upside of having your implants under the muscle is a lower risk of capsular contracture and better tissue coverage of the implant at the top portion of the breast. Sometimes releasing the inferior border of the pectoralis will help with this. In order to have it go away completely you would need your implants moved to a subglandular plane, which I wouldn't recommend given your preoperative photos. I hope this helps! Try to be patient. Best wishes, Dr. Meghan Nadeau, Seattle, WA
Do you think this is double bubble?
There are several options when it comes to revisionary surgery to improve your outcome. One option is to eliminate the pull of the pectorals major muscle either by completely releasing it or by suturing the muscle back down, thereby placing the breast implants in the sub glandular position. Patients who choose to have breast implants placed in the sub glandular position should have enough breast tissue coverage to allow for this conversion. There are disadvantages of placing breast implants in the sub glandular position (such as increased risk of breast implant encapsulation) which should be considered as you make your decisions.
Another maneuver that may be helpful is raising the inframammary fold using capsulorraphy techniques. In my practice, this type of repair involves a two layer, permanent suture repair (reconstructing the inframammary fold areas). This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation. Sometimes, depending on factors such as quality of skin along the lower breast poles, additional support provided by acellular dermal matrix or biosynthetic mesh may be very helpful. I have also found the use of acellular dermal matrix very helpful in cases where the skin/tissues are very thin and in cases of recurrent breast implant displacement. The acellular dermal matrix helps improve contour, improves irregularities caused by the underlying breast implant and/or scar tissue, and provides additional support ("sling" effect) for the breast implants.
I hope this, and the attached link, helps.
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Breast augmentation - do I have a double bubble?
- It is a little hard to say from your photos -
- It looks and sounds as though the indentation is caused by the lower border of the pectoral muscle
- But if your surgeon released your breast crease it might be an early double bubble.
- The best thing to do is to give yourself time and see how you heal.
- If the implants move further down - it is a double bubble.
- If they don't move down but the crease persists, you may need a revision to release the muscle or put the implants over the muscle.
- If you were my patient, I would want you to keep up your exercises.
Thank you for your question and photos. There does appear to be constriction remaining where your previous crease was and you may find that this gradually stretches out and softens over the next few months. I recommend that you follow up with your Plastic Surgeon if muscle related animation deformity continues to be an issue.
All the best
Do I have a double bubble?
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.