What Can I Do to Fix my Double Bubble? (photo)

I had a dounut lift/augmentation in Jul09 and within two weeks I noticed both breasts had dents under them. My doctor did a revision two mths later and removed the capsule and scored under the muscle. After the swelling went away the double bubble was back worse than before. This time we waited 12mts to do a revision were my implants were moved from duel plane postion to subglandular well I still have the DB but not as bad. What do you recommend I do now? I cannot stand to look at my breasts.

Doctor Answers 10

Double Bubble

Thank you for your question. This is a condition where the implant and the native breast are in completely different anatomical levels. Routine subpectoral mammary augmentation in women with a small breast lower pole deficiency often results in poor late results with the appearance of a double-bubble deformity. The surgical correction is complex and requires the need for a series of a. excision of breast tissue, b. pocket adjustment or capsulorrhaphy and c. exchange of implants or any combination of the above. Best of luck!

Dhaval M. Patel 
Double board certified 
Plastic surgeon
Hoffman Estates

Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 93 reviews

Correcting a double bubble problem

You have a double bubble that appears to be from a combination of the crease being too low and some breast tissue sagging off of the implant.  The implant appears to be submuscular.  This usually occurs when there is some pre-existing breast sagging or looseness of the breast tissue.  An inferior capsulopexy would be suggested to correct the problem.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Breast Revision?

Thank you for the question and pictures.
I'm sorry to hear about the problems you have had after surgery.
Although best to give you advice after direct physical examination,  I think you may benefit from revision of the breast implant pockets (capsulorrhaphy and/or use of acellular dermal matrix).  Capsulorraphy  involves the use of permanent internal sutures to reconstruct the lower poles  of the breasts;  this procedure they help to improve the contour of this area.
Consultation with plastic surgeons well-versed with revision breast surgery may be helpful.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

What Can I Do to Fix my Double Bubble? (photo)

Easier fix could be enhanced fat grafting into the constricted area. Plus you get some liposuction also. Additionally, re operation can help . Or the combination of these 2. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Double bubble

 The double bubble is a return of your original lower breast fold. Your breast implants now sit lightly below this breasat fold causing the double bubble. It sounds like your surgeon has done everything reasonable to try to correct the problem. Another revision may or may not be successful and it may be that yur problem is not correctable. You do have a nice result from augmantation of your breasts and the double bubble, although annoying, is the small imperfection that you may have to accept. Sorry it's probabl;y not the answer you want to hear.

Isolde Hertess, MD
Gold Coast Plastic Surgeon
5.0 out of 5 stars 4 reviews

Double bubble breast augmentation result

Hi there Double bubble is usually caused by lowering the inframammary fold either deliberately, accidentally or through downward pectoral muscle pressure and a weak IMF in sub pectoral augmentation. Your photos are interesting as the breast landmarks look fine. Preop pictures would be very helpful as it appears that you have not much coverage of your lower pole, and the IMF visible looks high. Did you have tubular breasts? My comments would be that your surgery does not look poorly done. I think your surgeon has done a good job and managed you appropriately. However, you don't like the appearance. Further treatment might involve IMF level adjustment, or fat cell grafting to the lower pole. I suggest talk with your surgeon about this as I think your confidence in him or her should be maintained. If you have very little lower pole breast tissue you might need to adjust your expectations. From your picture, this is no disaster and there are many positive things to say about your result. Good luck.

Double Bubble after Brreast Augmantation

The most common reason for double bubble after augmentation is the implants are too big and the inferior pole of the breast cut through the inframammary breast crease. As you already had corrections without correcting the DB, a better option would be to recreate the crease and support it with either allderm or stratice which reduces the pocket and settle for a smaller implant.


Raj Chowdary, MD (retired)
Allentown Plastic Surgeon
4.2 out of 5 stars 5 reviews

Breast augmentation - correction of 'double bubble' deformity

unfortunately you have experiened a complication that can often be difficult to treat.  It sounds like your surgeon has attempted some appropriate manuevers to improve your breast appearance.  You did not mention if anything was done to the inferior portion of the capsule (the tissue that forms around the implant), as this may significantly affect the way the inferior portion of the breast looks.  Additional treatments that can be considered are:  further adjustments to the capsule - tightening of the inferior portion internally, fat grafting of the lower pole of the breast may aid in smoothing the contour, rarely - removing skin from the inferior pole area if deemed to be excessive or significantly stretched.  A preoperative (before) photo would be helpful for decision making as well.

best of luck

Sean A. Simon, MD
Miami Plastic Surgeon
4.2 out of 5 stars 36 reviews

Breast Enhancement Surgery

There are many ways to correct this, I typically go through your old incision and suture the capsule to the chest wall and re create the infra mammary fold

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
4.9 out of 5 stars 76 reviews

Double bubble

As double bubbles go, yours is fairly subtle. It may be challenging to fully correct this. Scoring the crease where the old inframammary fold was may help. Fat injections may help correct the irregularity. A smaller implant along with capsule repair to recreate the old IMF in its original position may help as well. How bothersome is this to you? You might be better off accepting a good, though not perfect, result, rather than continue to undergo revisions. A consultation face-to-face is important for adequate advice. If you have copies of your preop photos, bring them to the consultation as well so we can figure out what your best options are.


Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 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.