Double Bubble or Swelling? (Photo)

I am 7 days post op. I had a capsulectomy on the right breast and implant exchange on both sides. I went from 400cc high profile round saline to 700 cc high profile round silicone. There has been puffiness under the right breast (which had the capsulectomy) since day 1 post op. My surgeon tells me not to worry and to wait 3 months for the impants to sette but I am worried that it might be a double bubble. Is there anything I can do now to support the fold to prevent a double bubble? Please help!!!

Doctor Answers 5

Double Bubble


Please keep in mind that these are just photographs, and a very important history and physical has not been performed, nor do we have the benefit of knowing your appearance prior to surgery or what happened during surgery, so an accurate assessment of the problem may be impossible in this forum. Having said that, I disagree with my colleagues regarding your concern. What else could be more than an inch below your natural inframammary fold? If you push on it and it feels like an implant, then it is not likely swelling, and it's not going to 'get better', and may perhaps get worse. Additionally, the upper pole of that breast is lower and not as full, indicating a lower implant position and a probable drop out/double bubble.

Unfortunately, the potential for disturbing the inframammary fold and creating double bubble is a very real possibility in the situation of a remove and replace surgery where the implant size has virtually doubled.  It is likely that your breast tissue and skin envelope on the side with the problem was always tighter and more tightly elastic. When the new implant was inserted there was limited expansion of the tight tissues, which in turn forced the inframammary fold to lift and the chest skin to be 'recruited' in order to accommodate the larger implant dimensions.

I am so sorry that you have gotten this problem, however for the benefit of women considering breast augmentation, you are an example of one of the most common issues associated with breast augmentation: complications associated with improperly sized implants.  There are very real limitations to breast augmentation surgery, and as a potential patient you should not assume you can get the same thing as your friend or someone you saw on line.  Breast augmentation is best performed by highly skilled surgeons with a real interest in anatomic analysis of the individual to determine the best implant size for that patient.  Unfortunately surgeon inexperience, or more likely economic pressures to never say 'no' to a patient can lead to these kind of problems.

I sincerely hope this resolves in a satisfactory way for you.  If however you need a revision surgery, it is more important than ever to go to a real expert in cosmetic breast surgery.

Best of luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 reviews

Double bubble

Yes it is, but it may correct itself over time.  It is best watched as your surgeon has suggested for now.  You may or may not need a revision, but these things can happen in secondary surgeries.  I am not aware of anything you can do  to alter the course.  It will work out. 

David Marcus, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 33 reviews

Post-op questions and concerns

are always best addressed by your surgeon since your surgeon knows what you started with, what was encountered during surgery, and what is anticipated.  Keep your faith in the surgeon that you entrusted with your care and to help you achieve the best result possible.  Your surgeon should be equally as motivated as you are to simple have the best outcome possible.

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

Seven days postop is too early to make a diagnosis of "double bubble".

Your breasts will reshape a lot in the ensuing weeks. There is a good chance that any contour irregularities that you presently dislikes will go away. You need to be patient while the healing process progresses.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Double Bubble or Swelling after Revisionary Breast Surgery?

 Although your concerns are understandable,  it is best to follow your own plastic surgeon's advise. Advice you receive online can be confusing  and will be based on  limited information. Remember that  your plastic surgeon knows exactly what procedure was performed, how you are progressing, has the benefit of in-person examination/evaluation, and is ultimately responsible for your care.  I would suggest that you run the exact question you have posted here by him/her. Best wishes; hopefully, you will be pleased with the long-term outcome of the procedure performed.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

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.