1 month post. 365 under muscle. Is this double bubble? (photo)

Hi jgriffin88,



Thank you for the question and the photo. I understand your concern.



Bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.



Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.



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.



If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.



Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Hello jgriffin88,
I’m sorry for the adverse symptoms you’re experiencing. Based on your pictures and description, you seem to have snoopy deformity of the left breast (double-bubble). This post-surgical complication happens when an implant drops down behind the natural fold (inframammary crease) where the lower breast meets the chest, rather than forward into the breast. This shifting creates an unnatural indentation or line across the bottom (lower pole) of the breast. Partial Submuscular breast implant placement (under the muscle) is typically more painful, have a significant risk of double-bubble (snoopy deformity of the breast), breast animation and distortion may occur when the pectoral muscles contract, and it’s associated with a longer period of recovery and more post-operative discomfort. The risk of double-bubble occurring may be reduced by choosing the Dual-Plane implants placement instead. Double bubble can also occur when Implants are too big (heavy) for the chest wall and cause the supporting tissues to stretch, settle or migrate below the inframammary crease, and/or the mammary crease is constricted. There are several ways to correct double bubble, all of which involve surgical intervention. The right double bubble correction for your situation should be determined during a consultation with your original plastic surgeon. Since your breast augmentation was recent (within the past six months), your surgeon may advise a "wait and see" approach to determine if it improves on its own. Hope this is helpful! Dr. De La Cruz. 

You look pretty good actually. Early double bubbles can improve dramatically with time. I would suggest you follow up with your surgeon all the way out to 12 months after surgery to see the final result. Good luck.

Based on the photo, you do seem to be experiencing double bubble. Your best course of action would be to schedule an appointment with your board certified plastic surgeon for an in person examination and a detailed discussion of your revision surgical options.

Hi and welcome to our forum!
Congratulations on your recent surgery. From your photographs, there appears to be an infraareolar flattened area of the left breast. The breasts appear to be of equal height and the scars at the fold beneath the breasts appear equal. This does not appear to represent bottoming out, but may represent a localized constricting band of tissue or swelling of the breast tissue in that area. As you are only 4 weeks out, there will still be significant remodeling of the skin and soft tissue to accommodate the added volume and weight of the implant. In most instances, this will stretch out over time, but if it persists, a revisional procedure can be performed to correct it.
Continue followup with your plastic surgeon. Make him / her aware of your concern at your next visit.
Best wishes...