Do I Have a Double Bubble? I was told it was swelling and the implant would settle. (photo)
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Doctor Answers 5
Thanks for the photos. It is hard to see real well, but it does look like you have some evidence of this in the left breast. You will likely need a revision.
Double Bubble Deformity
From your photos, it does appear that you have a double bubble (although mild) most notably on the left breast. This is likely from lowering of the breast fold and the fact that you should have had a breast lift to start (in addition to the implants). I don't necessarily understand why a larger implant couldn't be used, but this is something to discuss with your surgeon. Fortunately, this is a problem that can be fixed, but you should wait 4-6 months from your surgery to have enough capsule to re-elevate the breast fold. This should be combined with a lifting of the breast/nipple and areola at the same time to correct the nipple position once the fold is reestablished. See an experienced plastic surgeon who is comfortable with secondary breast surgery.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon
Although the post operative photos are not very telling, I understand what you are describing. You can see a vague outline of the implants at the very depth of the inframammary fold, then your natural fold is visible slightly above it, with the fulness of your breast projecting out from there. This is a double bubble, and this is due to excessive lowering of the fold, which was done intentionally by your doctor.
The reason the doctor could not put in a larger implant was because he realized during your surgery that a larger implant would require lowering the fold too much, not because of your little frame. Although I agree that a 450 cc implant is probably too big for you, the real issue is that you needed a breast lift and the doctor was trying to get the implants low enough to 'lift the breast', something that can't be done. Looking at your pre operative photo tells the real story: the majority of your breast and your nipples hang below your inframammary fold.
Although it is very early, it is unlikely this double bubble will improve, and in fact may worsen as the implant settles into your thinner chest skin that covers it. Additionally, your nipples will not move into a more youthful postition with settling. A revision surgery to only fix the double bubble will reveal the underlying problem of breast ptosis (sagging) and you will not be happy with that appearance either. Therefore, any further surgery should include fixing the double bubble and a breast lift. No surgery should be performed for three months, so you have time to think about whether to leave well enough alone, or revise your breasts properly.
Best of luck.
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Do I Have a Double Bubble?
Posted photos show a lowering of the infra mammary fold, thus causing a crease. And I agree with Dr Rand with the issue about implant size. Only if he/she could not insert the larger implant is there a reason to go smaller than you anticipated. Sorry but YES you will most likely need revision.
Breast implant questions
I can't see from the photos if you have a double bubble or not. Also, I can't imagine why you and your doctor didn't work out exactly what implant would be used preop. Waking up with a surprise is not the usual thing in my opinion as all the measurements can be made preop and the proper implants chosen. It does look like you might have been able to accomodate a slightly wider implant than you have in right now.
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