Do the Size, Width or Projection of the Implant Impact the Risk of Double Breast? (photo)

On a consultation for breast augumentation I got the information that i had to acount for a smaller double breast contour/shadow line between the implant and my own tissue, due to more glandular tissue then fat tissue ( I'm very thin 173 cm 54 kg). I am interested in anatomic implant Allergan Natrelle 220 cc ML. Do the size, width or projection of the implant impact the risc of DB? How can reason to minimize the riscs?

Doctor Answers 4

Double bubble is caused more by your anatomy than the implant

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Thank you for your question. The main cause of a 'double bubble' is a high fold under the breast when the implants are placed. This is something that you can just be born with.  The implant will lower the crease a little normally.  If the implant actually sits below the normal crease so that a new crease exists an the bottom of the implant, the natural crease is up on the breast causing a double bubble. The implant shape and style are not the cause. Based on your photo, in my opinion, you should not have a problem with a double bubble as your natural crease appears to be in a normal position.

Columbus Plastic Surgeon
4.8 out of 5 stars 40 reviews

Double bubble breast

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Double breast results when the implant is at one level and the patients breast tissue at another.  A silicone implant properly placed retro-pectoral of only 220 cc's should not result in a double bubble appearance.  The size, width or projection does not determine the double bubble.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Size, width, and projection of implants in risk of "double breast"

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I would disagree with Dr. Pousti's otherwise excellent answer in that for elective, cosmetic surgery, the decisions should be made by the patient and surgeon before the operation and not during the surgery. Although it cannot be measured exactly, the general issues and results from different implant choices can be known before the surgery from experience and measurements. 

"Double breast" is not an adverse condition. You may be thinking of "double bubble". All augmented breasts have a transition from natural breast tissue to synthetic implant volume to a greater or lesser degree depending on factors such as whether the inframammary crease has to be lowered or not and how much breast tissue is in the lower pole of the breast. Silicone gel implants blend this transition better than saline implants but it's more related to the breast conditions than the size, width, and projection of the implant (assuming these are matched properly to the breast). 

Double-bubble problems are mostly related to the release of the fascia (connective tissue) and pectoralis muscle edge in the lower pole of the breast. Implants that are too wide will tend to aggravate this as well as losing control over the inframammary crease level. 

I would also question the need or desirability of the "anatomic shape" breast implant in a typical round breast such as the one shown.

Scott L. Replogle, MD
Boulder Plastic Surgeon

Selection of Best Breast implant Size, Width, Projection?

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Thank you for the question.

Yes, the variables that you mention can increase risks of a variety of complications after breast augmentation surgery.

I would suggest that you do the following:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This if communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural”  etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I would also suggest that you educate yourself regarding the potential downsides of “anatomic” breast implants (such as potential rotation and  change of breast shape).

I hope this helps.

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.