What is the issue with my breast implants? How can this be fixed? (Photo)

Question

I would like to know what issue I’m experiencing with my breast lift/implants. Procedure was done in 2020. Complained to doctor about what I started noticing and he did a fat transfer which did not work. Said everything looked better than before surgery so I should be happy. But now things have progressed more. Mostly in left breast.

Richard Baxter, MD · Answer

The photo has the appearance of the type of double bubble that is caused by pectoral muscle release, in the same way that it can cause animation deformity. This is not uncommon with dual plane placement because it requires detachment of the muscle. Does the crease pull upward when you contract your pectoral muscle? (Check by pushing the palms of your hands together.) If so, the way to correct that is by re-attaching the muscle, which requires converting to either the subfascial plane or split muscle. If that is the cause, then no amount of fat grafting will help.

Donovan Rosas, MD · Answer

A double bubble occurs when an implant descends below the level of the original IMF. This creates the illusion of a second fold at the lower level to which the implant settles.

This can be corrected via surgical revision to re-establish the fold and relocate the implant to a higher position. An implant exchange (downsize) may be indicated as well. Alternatively, an attempt can be made to (further) release the crease and allow the implant remain at its current position resting on the newer (artificial) fold. Typically, fat grafting is not an adequate fix.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Wayne I. Yamahata, MD · Answer

It appears that you have a double bubble and the implant is sitting below the original inframammary crease. There are a number of options that could be considered to treat this. These options all have positives and negatives. Discuss these options with your surgeon. The option you choose would depend on your goals and willingness to compromise.

Gary M. Horndeski, MD · Answer

You have a double bubble. This appears to be from the old inframammary fold. The attempt to hide the double bubble with fat transfer was unsuccessful. You will need release of the fold surgically and may need a different size implant.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear Rpg1979,

though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

Your implant is too big. Surgeons are afraid of loosing a potential patient by telling them that; we've inadvertently made a generation of women think that they can get any size implant they want regardless of their anatomy. That crease is your original inframammary fold riding up onto the implant. Your fat grafting surgery represents another failure by your surgeon to either grasp the concepts, or worse, simply to mollify you with a Hail Mary procedure that would've never helped. You'll need a smaller implant, a capsulorrhaphy, and a formal mastopexy.

John LoMonaco, MD, FACS · Answer

You have what is known as a "double bubble" breast issue, which happens when the breast implant falls below your normal breast fold. This leaves your natural breast sitting above the implant with an unnatural crease or fold.

The fix is to move the implants higher and reconstruct the breast implant pocket. Sometimes the size or profile of the implant also needs to be changed.

Steve Laverson, MD, FACS · Answer

There are several "issues," the most obvious being a visible linear differentiation between your implant(s) and your native breast(s).  Implant edge visibility is another feature, animation of the implant with pectoralis major muscle contraction, and if "things have progressed more," probably capsular contracture. Hard to understand entire situation without more information and an in-person examination. Hopefully you'll be able to improve your outcome;  additional surgery will likely be indicated.

Cihan Sahin, MD · Answer

You have capsular contracture. And you need a surgery to fix this. Capsul should be removed and implants should be changed.

Ralph M. Rosato, MD · Answer

Your breast implant has slid below the natural crease of your breast. It can be corrected with a surgery. You may have to use a smaller implant. A consultation with your surgeon will help.

What is the issue with my breast implants? How can this be fixed? (Photo)

Answers (12)

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