Fat grafting for double bubble? (photo)

I had 470 CC silicon implants in December and I have noticed a double bubble when I raise my arms up. My doctor who I did lots of research on and has good experience, but I was surprised when told me he would use fat grafting to fix it but I am not sure how I feel about that as I read it should be redone. I don't want to go smaller at all. I don't know if fat grafting for my situation is a good idea or not? I want it fixed correctly.

Doctor Answers 6

Options for double bubble correction

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Correction of double bubble depends on the cause. There are 3 possibilities that I can think of from the photo:

  1. Breast tissue sagging over the original fold. This would be more likely if there was some sagging to begin with, in which case some sort of lift rather than fat grafting would be best.
  2. Animation retraction. If you see the fold pulling up when you flex your pectoral muscle, then it is related to the muscle detachment from dual plane placement. That would be correctable by conversion to the split muscle.
  3. Lowering the fold. If your surgeon lowered the fold a little bit in order to accommodate the diameter of the implants. That could be improved with fat grafting or a capsulorrhaphy. 

Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Double bubble correction

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The double bubble deformity primarily occurs because your surgeon has attempted to lower the inframammary fold. The inframammary fold or fold beneath the breast, however, is more resistant to stretching and therefore this has resulted in a tight band beneath the breast. It is possible that the inframammary fold was lowered accidentally. However the inframammary fold is lowered intentionally if the folds beneath your breasts are uneven to begin with or if the inframammary fold to nipple distance is particularly short. Regardless of the reasoning, the traditional approach is an inferior capsulorrhaphy or "internal bra". However fat grafting for the breast has become much more commonplace. This may be a perfectly appropriate approach to correcting the double bubble appearance that you have. Most importantly talk with your surgeon and express your concerns about the method of correction. He or she should be very responsive to explaining why they have chosen this method. Thanks and good luck.

Paul B. Mills, MD
Saint Louis Plastic Surgeon
5.0 out of 5 stars 16 reviews

Redo breasts augmentation

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   Dear Nickie,

      Thanks for submitting your picture, though full  front and side view pictures would have been very helpful.  

    The cause for double bubble deformity is stiffness of the sub mammary fold that will not  stretch, when the surgeon tries to lower it in order to create  the appearance of perkiness. The best corrective procedure is inferior capsulorrhaphy (internal bra) , which will recreate the integrity of the fold. At times, tough,  based on physical  examination and patient's personal preference , a mini lift will be very helpful to create beautiful perky breasts.

   Your best option (financially) is to have the procedure done by your original surgeon. If he or she are not responsive and you are really troubled by your condition, consult with experienced board certified plastic surgeons who do lots of redo breasts augmentation. Check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking. Also, check the reviews on 'RealSelf' for ratings and positive experience reports.

                                  Best of luck,

                                                  Dr Widder

Scar retraction

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Looks more like scar retraction that would benefit from release and fat grafting then a true double bubble deformity. It sounds like you plastic surgeon is doing the right thing. Good Luck!

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 62 reviews

Fat grafting will help

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Thanks for the great question and the photo. The way to treat the deformity you have is with face grafting. Placing additional fat in the thin skin near your fold will help to even out the appearance of the tissue. Best of luck in your area!

~Dr. Sieber

David A. Sieber, MD
San Francisco General Surgeon
5.0 out of 5 stars 40 reviews

Deformity after augmentation

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I agree with your surgeon - fat grafting to treat this deformity after an augmentation would be what I would recommend (based on your photos alone), as well.  If you're uncertain about this treatment, discuss it and other options such as revision augmentation with your surgeon to come up with the best treatment plan for you.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 12 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.