Can Double Bubble Be from Swelling and Go Away over a Few Months?

Question

I have a double bubble on one side still after 4 weeks. The tissue under the original crease is discolored (was bruised) and quite tender. My PS says it is swelling and definitely not double bubble. If it were swelling wouldn't it be gone by now? Didn't think DB could be caused by swelling?

Otto Joseph Placik, MD · Answer

Double bubble can be temporaraily caused by swelliing, edema or hematoma. I would use a reinforcement along the crease.

Peter A. Aldea, MD · Answer

What YOU are referring to as "Double Bubble" may or may not be a double bubble deformity. Without a photograph, none of us can confirm it.

	A Double Bubble is the demonstration of residual tissue memory in which the incompletely released, persistent constriction of the breast fold indents the lower pole of the breast implant. If this is very pronounced, it will not get better with time and would require surgery to release the breast fold arc. If it is swelling, it should resolve by 6-8 weeks after surgery.

	Discuss this with your surgeon.

Vincent P. Marin, MD, FACS · Answer

A double bubble results from the implant descending beneath the existing breast crease (inframammary fold) and the memory of the skin produces an indention within the implants lower half resulting in two bulges or the "double bubble" appearance. This is classic in its appearance an not routinely related to swelling of the breasts. Does the implant appear to be lower than the other side? I would recommend revisiting the issue with your plastic surgeon and photos would be helpful to provide you with a diagnosis.

Best of luck.

Vince Marin, MD, FACS

La Jolla Plastic Surgeon

Best of luck.

Vince Marin, MD, FACS

La Jolla Plastic Surgeon

Steven Wallach, MD · Answer

Can not give you a definitive answer without seeing photos.  Swelling certainly can occur.  Sometimes a compression garment by the fold can help, but ask you surgeon.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  Hopefully the swelling you see is simply tissue swelling or fluid collection.  However if it is a true double bubble with displacement of the implant below the inframammary crease it is unlikely to heal and will most likely require revision

Scott L. Replogle, MD (retired) · Answer

In general, a true double-bubble deformity is not caused by swelling and will not go away as swelling subsides. It might look more or less noticeable as the swelling resolves.

	I disagree with the other opinions regarding what causes a true double-bubble deformity but it sounds like your problem might be a pocket of blood in the lower pole or area of the inframammary crease that was not recognized and evacuated. This might or might not resolve on its own satisfactorily. The situation could resolve if it's only been four weeks but often it's difficult to know what is not settling properly, what will happen, or how best to manage it. Generally at least three months is needed to give the tissues a chance to recover. If it doesn't then the issue is if it's correctable and how best to do that.

David A. Ross, MD (retired) · Answer

It is possible that the protrusion beneath your breast represents swelling and is not in fact a double bubble deformity. This holds true even at the 4 week interval. If the fold under the problem breast is as well defined as the "good" side then a double bubble may not be the problem. Certainly, if there is still an issue when you reach the 2 to 3 month period after surgery the double bubble becomes a definite possibility.

Can Double Bubble Be from Swelling and Go Away over a Few Months?

Answers (7)

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