Deformity Under Breast, What Do You Think is My Problem? (photo)

I had BA 6/1/12 Submuscular 650cc sil. HP. Was c cup before I got capsular contracture in left, & had scar tissue attached from old crease to muscle. Revision 2 weeks ago to fix, now left breast good, but right the same, just more droopy, he keeps saying "we're fighting the shape of your natural breast" my natural breast wasn't deformed though.... Do you think this will fix itself? What do you think my real problem is? If it won't fix itself what do I need to have done to make it look normal?

Doctor Answers 7

Post-op Fold Issue

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I agree that what you're seeing is a 'double-bubble deformity.  This is a large implant and it is a bit tight under your muscle and the implant protruding in your fold from under the muscle likely feels firmer than you would expect.

The reason why this happened is because your breast, which was likely a little 'droopy' to start with is somewhat large to begin with, and it sits over the muscle independent from the implant.  The result is that, even with a high profile implant of this size, the implant diameter is too wide for your breast.  Elevating the implant would correct the fold issue, but would result in even more fullness in the superior portion of your breast.

There are several choices, each of which involves some compromise.

1- Switch to a smaller implant- you will be smaller but, with the smaller diameter, you may be able to correct the fold issue.

2- Mentor now makes an 'Ultra' high profile implant that will give you the same volume with even  more projection, but less diameter.  This will give you some advantage, but not correct the entire problem.

3- A mastopexy (breast lift) that elevates your breast gland so it is more central over your implant will likley correct much of the issue although the fold may need to be reinforced as well.  This will give you more scars but definitely a better result.

4- Changing the position of your implant to the over muscle position will easily solve the issue...but there are some issues with this...including an increased risk of capsule contractures and the potential for confusion on mammograms in the future.

I'd need more photos to give you a true opinion but, based on what I see, I'd likely suggest that you change to a smaller implant and add a mastopexy.  Without a mastopexy I think the best cosmetic result will be with an over muscle implant...although I'd try to convince you otherwise.

Good Luck!...Dr. Newman

New York Plastic Surgeon
4.9 out of 5 stars 42 reviews

Possible double bubble after breast augmentation

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Thank you for your question and photo. The area that you mentioned may be a double bubble which AZ implant was placed below your inframammary crease. Please see your plastic surgeon

Deformity Under Breast, What Do You Think is My Problem?

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The implant was placed below the medial infra mammary fold. This was either to correct asymmetry or some deficiency. Best to discuss with your surgeon in detail. 

Breast issues after augmentation

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There are always things that can be done to achieve a better result.  Unfortunately, they usually will involve some additional costs to the patient so patient motivation to change things really matter here.  Pursuit of perfection can often lead to other problems and imperfections.  Stay in contact with your surgeon and make sure he/she is aware of your concerns.  And really think about how bothersome your concerns are.  To better appreciate things, look back at your pre-op photos as well.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Deformity Under Breast

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The crease that is visible on the right side represents what we call a "double bubble."  There are two likely causes. The more likely is that this fold is an indentation from the original breast fold (seeing a pre-op photo would be helpful). The less likely it that this is the the lower edge of the pectoral muscle.  Which of the two it is can be resolved by examination.

If it is the more likely of the two, the best solution would be to switch out to a smaller implant, and to reconstruct the original fold. If only the fold were repaired, the implant would likely  be pushed too high toward the collar bone. All this is based only on photos, and the photos alone are not enough for any recommendation that counts!

At any rate, I would urge you not to do anything for 3-6 months since you are so close to your recent surgery, and some improvement is yet possible. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Deformity Under Breast after Revisionary Breast Surgery?

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I am sorry to hear/see the concerns you have after breast revisionary surgery. Although difficult to give you good advice online, I think that the “deformity” you are seeing/describing is the breast implant that has moved below your natural breast crease. At this point, postoperatively, there is not much to do but allow for more time to pass. It is hard to say whether or not the results will improve with time but best to evaluate the end results of the procedure performed six months to one year postoperatively.

 If the situation is not improve, it is possible that you may benefit from capsulorraphy (see attached link) surgery to improve the positioning of the breast implant ( if this is indeed the case based on physical examination).

 I hope this helps.

Deformity Under Breast, What Do You Think is My Problem? (photo)

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Your PS appears to be correct in his assessment. Your inframammary crease was too high for the size implants that you chose to have. Had he used your natural crease, the implants would be up around your collar bone, but he had to lower the crease so that your nipple is in the center of the implant. The groove you see is actually your natural crease.

How do you correct it? It will be difficult to correct it completely, but fat grafts may be your best chance in my opinion. The grafts can be placed in the groove itself.

It's a tough problem, and there is no simple solution. Good luck with it though.

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.