Double Bubble Result from Breast Augmentation?

I had breast augmentation in April 2010. I had the dual-plane technique with 300cc, moderate profile, smooth, round, silicone with an inframammary incision. As you can see there is the illusion of two breast creases. Also, when I contract my muscles, my breasts look particularly odd. I don't know if I should consider corrective surgery or wait until my implants are due for replacing.

Doctor Answers 12

Breast Augmentation Double Bubble Correction Requires Implant Revision Surgery

Thank you for your question. Be sure to consult your surgeon for advice.

Your photo suggests that there is a double bubble following your Breast Augmentation.

Correction of a double bubble requires surgery to reconstruct the infra mammary crease or fold beneath your breast.

In my experience the surgery is usually quite successful.

However if you are happy with your breast appearance and the double bubble does not bother you then leave it alone.

Any revision surgery does increase the risk of capsular contraction, so if you are not troubled by the double bubble then why take the risk.

PHOTO: Timing of double bubble surgery correction

Due to the fact that it only appears with extreme maneuvers (arm in the extended raised position or with muscle contraction) I would not advise any corrective surgery now.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Is this a double bubble?

From the picture it does appear that you have a double bubble deformity.  This is caused by the following:

  • excessive lowering of the infra-mammary fold
  • residual appearance of the native infra-mammary fold

Unfortunately, this is becoming a more common finding and can be associated with a number of factors such as a too agressive lowering of your fold as well as implants that are too large for your breasts. 

To fix this, the standard treatment plan involves the following:

  • slight downsizing of the implants
  • tacking down of the original breast fold
  • possible reinforcement with an acellular dermal matrix
  • taping of the fold for several months (for reinforcement)

This is most likely not going to get better and could, in fact, get worse over time.  Your best bet is to speak with the Plastic Surgeon who performed your original surgery and express your concerns.  If he/she is not comfortable with this type of repair then ask for a referral to someone who is. 

Properly treated and addressed early, you can most likely achieve a result that looks more optimal and that you will be very happy with in the years to come.

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
4.9 out of 5 stars 42 reviews

How much does it botheer you?

The real question is how much does the double bubble bother you.  If it bothers you enough then you can do something about it.  It appears fdrom this photo that the implant has descended below the inframammary fold and the breast has bottomed out.  If this is the case after discussing it with your plastic surgeon, you can undergo a revision with repair of the crease to raise the breast either with or without alloderm to reinforce the crease.  What I am seing in the photo may be different in real life so this is something that shoul;d be addressed with your plastic surgeon.  Good luck, Dr, Schuster in Boca

Steven Schuster, MD, FACS
Boca Raton Plastic Surgeon
4.0 out of 5 stars 6 reviews

Double Bubble Result from Breast Augmentation?

I am sorry to hear about your concerns after breast augmentation surgery. One of the most common complications after breast augmentation surgery is implant malposition. This occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (“riding high”), inferiorly (“bottoming out”), medially (“symmastia or uni-boob”) or laterally (falling outward into the axilla).

It looks like you might have double bubble after your revisionary surgery. A "double bubble" is a cosmetically undesirable circumstance for patients with breast implants, which occurs when the breast fails to take on the shape of the implant, resulting in the appearance of a visible line showing a separation between the bottom edge of the implant and the bottom edge of the natural breast. Sometimes, in situations like yours, the appearance of the breast improves over the course of the first several months; sometimes, additional surgery may be necessary to improve the outcome.
This is corrected by “raising” the inframammary fold using internal sutures (capsulorraphy). I have also found the use of acellular dermal matrix very helpful in cases where the skin/tissues are very thin.

I hope this, and the attached link, helps.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Revisional Surgery Needed

It’s not unusual for patients with mild to moderate breast sag to present for breast augmentation surgery.When this situation arises, these patients are often eager to avoid scarring which is associated with breast lift surgery.Various strategies have been utilized to accomplish this goal, including dual plane breast augmentation.Unfortunately, these techniques aren’t always successful and patients are left with persistent breast sag, persistent inframammary folds and a double bubble deformity.
Although it would be helpful to have pre-operative pictures and be able to perform a physical examination, your post-operative pictures suggest the presence of a persistent inframammary fold and a double bubble deformity.
In patients who have had biplanar breast augmentation, this problem often improves in the immediate post-operative period.Under these circumstances, the weight of the implant stretches and expands the tissue that’s been recently released.Unfortunately, after six months, further expansion of the soft tissue is unlikely and this deformity becomes more or less permanent.
Under these circumstances, revisional surgery will probably be necessary.Revision would probably require bilateral breast lift surgery.In some cases the inframammary fold may require reconstruction as well.It’s important to discuss these issues with your plastic surgeon.Your surgeon should be able to formulate a plan that addresses your concerns.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Double bubble

This is a double-bubble deformity and is the result of the lowering the lower breast crease.  It does happen ocassionaly with breast augmentation.  You should go see your board - certified plastic surgeon and discuss options for correcting this with them.

Samer W. Cabbabe, MD, FACS
Saint Louis Plastic Surgeon
4.9 out of 5 stars 57 reviews

Double bubbles

Yes, this is a double bubble where the old IM crease indents the breast above the new crease.  I'd suggest you go ahead with revision if it bothers you because there is no time in the future when your implants will be "due for replacing."

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Breast augmentation

Yes, it is a "double bubble".  Correcting them will depend on how much it bothers you.  Correction is not always as easy as it sounds.  A dual plane approach is one way, but sometimes it can only improve it.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 reviews

Breast implants

the double bubble that is seen after breast augmentation is the persistance of the original inframammary crease when it is lowered at the time of surgery. By 7 months, if this had not improved then it most likely will not resolve. The decision on revision is personal and how much this bothers you.

You need to visit with your surgeon to discuss what they think are you best options. There are things that can be done to help that.

Jack Peterson, MD
Topeka Plastic Surgeon
4.5 out of 5 stars 39 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.