6 weeks post op - am I developing double bubble? (photos)

Hi there, Thank you for your question. What you are seeing there is your natural breast sitting on top of your implant. If you have a concern, speak with your surgeon. Best, realdrsix

I'll try shed some light over your case and situation, I detect several conceptual errors in your understanding and patient information, among which be so kind to find the following ones, not limited to them:
-no one breast implant is "fully sub muscular", and yours is not an exception; your implants are partially under the muscle, aka known in a posh way as "dual plane", term I really find trivial, incorrect and non defining, when for real the implant is partially covered under the muscle (upper 30% under muscle, lower 70% subglandular; no one pectoralis muscle is spans enough to cover the whole implant); nowadays no one implant is performed with the banned, proscribed and disastrous "fully submuscular plane", as it was done in the 90s, since it leads to grotesque derformities, implants dynamism (aka "elevator breasts) and early rupture due to rubbing against the bony rib arcs. Nowawdays it is very much acceptable performing partial submuscular plane with implants of 3rd, 4th and 5th generation (I do not see the point for 1st or 2nd generation models, due to unacceptably high rates of complications and poor results); I have been enthusiastic user on more than 2000 patients of the partial submuscular plane in the first decade of my career, however I moved to the subfascial plane many years ago and I would not return to submuscular placement; with the subfascial I achieve the same or somehow better aesthetic outcomes (better cleavages), increased postop safety and better / quicker recoveries; in practical terms both, partial submuscular and subfascial are equally valid and state of the art, however more and more surgeons are moving to subfascial, with a quick note of exception: only implants of the 4th and 5th generation are made to be used subfascial) and I strongly advocate the use of subfascial due to all its undisputable advantages (minimal pain, low rate of complications, minor invasiveness, better recovery, etc.); with that said, I can tell you in my old era of submuscular placement I could achieve very brilliant results, and I do obtain nowadays very similar results using subfascial with some relevant enhancements (as the mentioned cleavage), so no blemish on the partial submuscular... as long as... it is properly executed
-however, there is a veeery very typical deformity associated with the partial submuscular breast, caused by the surgeon when he fails to understand the intrinsic anatomy of the submammary crease and its interaction with the pectoralis muscle: the animated double bubble deformity (not equal to the double-bubble deformity of other casues) or dynamic breast flex deformity (not equal to the dynamic implant flex deformity), and you seem to suffer this animated souble bubble deformity or aka dynamic breast deformity; the cause is simple, has an easy fix and it is hard to understand why so many surgeons fail to cope with this technical refinement: the pectoralis muscle has at its lower edge firm attachments to the ribs, this is well known by surgeons, but may doctors fail to know the pectoralis issues very firm and powerful ligaments or attachments connecting this its lower edge with the breast skin at the submammary crease, and here you have the cause of your deformity; one of the critical steps in doing a successful partial submuscular breast augmentation is... releasing properly the pectoralis muscle lower end from the ribs (otherwise you'd get a dynamic implant flex deformity), which seems was done in your case... but it is also of paramount importance releasing, as well, the pectoralis muscle lower end from the submammary skin, which seems was not done completely in your case, and failing to do so leads to a persistent double submammary crease which is severely and unsightily deepened like a hack when you contract the pectoralis muscle, which then pulls in from the original submammary crease forming a ditch at the submammary breast pole; the fix is very easy: open surgically and release the adhesions between the lower edge of the pectoralis muscle and the skin, letting the muscle glide free above the implant without any connection between breast and muscle which might lead to animation / dynamism-your surgeon did not mention you about lowering the submammary fold as he did neither mention he would use scalpel, sutures and a needleholder... those are inherent elements of a breast augmentation; whenever a breast grows it does expand over the ribcage, growing in all ways and gaining territory... to top, sides, cleavage and also... to the bottom or lower pole, so this is not only well done in your case but also a must-do, otherwise you'd have too high riding implants and nippled facing down-the visibility of the original submammary crease above the line of the new submammary crease (built to host the implant) can be normal and temporary in many patients, this normally fades away overtime, however... failing to realease the pectoralis muscle from the original submammary crease makes this original submammary crease a persistent one; the fact the original crease is dynamic and deepens with the contraction leads to the conclusion the muscle is attached to it and, therefore, the crease is unlikely to disappear
Hoping you can now understand your situation, now I my opinion as expert in revisions: you'll have to wait about 6 months to let the tissues recover, and then get revision to release the mucle from all its attachments to the breast gland and the breast skin, as easy and simple as it sounds, terminating.
If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, in both relaxed and contracted (pectoralis) positions.


Feel free to request any additional information from me.

Thank you for your question.  Because of the asymmetry that you had before surgery it is likely that her surgeon needed to lower the fold on the right side.  The fact that the line that you see gets worse when you tighten your chest muscle may indicate what you are seeing his the bottom edge of your pectoralis muscle and not a  double bubble. Hopefully with time the implant will stretch and thin the muscle and this  line will become less noticeable.  Of course discussed this with your plastic surgeon.  However I would do nothing now put weight to see if as the muscle fins from pressure of the implant this line becomes less noticeable.