Too Low Pocket or Crease Caused Double Bubble Deformity?

I have Double Bubble deformity on my left breast, where the implant hangs below actual breast instead of filling it in. Was the pocket or crease too low? I didn't have saggy breasts, but did have short inframammary crease. L-7cm ,R-6cm. Doctor denies any corrective measures available. States, "deal with it". What can be done about this?

Doctor Answers 4

A short crease to areola distance is a hard starting point

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If there is a skin deficiency in the lower pole of the breast as evidenced by a short crease to areola distance (ie 2-3 cm), it is necessary to borrow some skin length and lower the crease a bit. This opens up the possibility of a "double bubble" forming as the old crease retains its memory and causes an indentation across the lower pole of the breast with the new crease below that. If you are unhappy with your doctor, seek another opinion. Dr. James Grotting in Birmingham, AL is a leading breast surgeon and expert at all breast issues.

"Double Bubble" appearance to breasts following esthetic breast augmentation

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Your surgeon was correct in that there is probably no simple way for you to eliminate the “double bubble” appearance and achieve a classically attractive appearing breast. Dr. Rand has eloquently explained the reason for the “double bubble” being caused by the original fold beneath your breast.

The most common treatment of this condition is to reattach the fold back to the chest through a procedure called a capsulorrhaphy or capsuloplasty. As you appear to have a relatively short distance from your nipples to these folds, the appearance following this procedure would be less than ideal.

Your nipples would likely be centered relatively low on the implants giving your breasts an elongated or long appearance. Having said this, I still think this would look better than your current “double bubble.”

Also, if the long appearance of your breasts is unacceptable it could be improved with a mastopexy or breast lift.

I hope this is helpful. Best of luck and I hope you achieve the appearance you desire.

Too Low Pocket or Crease Caused Double Bubble Deformity?

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I am sorry to hear about the complication you have experienced. The double bubble phenomenon usually represents  a problem along the lower pole of the breasts,  where one can feel/see the breast implant below the “previous” infra mammary fold area. One “bubble” is caused by the breast implant, the other by the breast tissue.

Reconstruction will likely involve the use of sutures to repair the breast implant capsule and reconstruct the inframammary fold areas. The use of additional supporting material such as acellular dermal matrix or biosynthetic mesh may be helpful also.

Make sure that your plastic surgeon has significant/demonstrable experience helping patients with this type of revisionary breast surgery. You may find the attached link helpful to you as you learn more. Best wishes.

There are corrective options

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The double buble deformity is a risk with breast augmentation and more so with a short IMF to nipple distance. It is also difficult to correct but there are options to discuss with your surgeon. Did it occur on both breasts? Your measurements are not too far from the norm. Try to discuss your concerns with your surgeon again and bring up the possibility of using alloderm to support the lower pole of your breast to correct the double bubble deformity. Good luck.

Bahram Ghaderi, MD
Chicago Plastic Surgeon

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.