3 Mos. Post Op Right Breast Looks Deformed, Mishaped, Can Feel Implant at Bottom of Breast Why? (photo)

I am very unhappy and want to know what I can do fix it but first would like to know what is exactly that happened here why does my breast look this way?

Doctor Answers 10

Double Bubble following breast augmentation

The indentation along the inner part of the breast may represent a "double bubble". These can sometimes be hard to treat. If the implant is underneath the muscle, it may be that the pectoralis (chest) muscle needs to be released further along the rib leading up to the sternum.

If the contour is due to scar tethering, the scar tissue would need to be released. Recent reports in the medical journals have cited good results with using sheets of acellular dermal matrix (ADM) is these cases.

No matter what the cause, you need to go back and see your original plastic surgeon.


Good luck with it all.



3 Mos. Post Op Right Breast Looks Deformed, Mishaped, Can Feel Implant at Bottom of Breast Why?

    This could be due to tethering, inadequate release, or any number of things.  What to do will be based upon exam when flexing the pectoralis and in relaxation.   Just make sure you find a plastic surgeon with ELITE credentials who performs breast augmentation revisions on a regular basis.  Look at before and after photo galleries on the surgeon's website to determine who can best address your needs.  Kenneth Hughes, MD Los Angeles, CA

Breast implant revision

From your photo, it looks like this is either the edge of your pectoralis muscle or a persistent inframammary fold.  This can be very, very tricky to correct, especially if the breast tissue is thinned out this area. 

Surgical revision will likely be necessary and may consist of changing the location of the implant, changing the size of the implant, releasing the muscle edge or fold, modifying the implant pocket, and/or using an acellular dermal matrix product such as Strattice.

Be sure you go back to your surgeon with your concerns.  He/she will want to get you a result you are happy with.  If he/she is unable or unwilling to help you, you should get a second opinion from a surgeon certified by the American Board of Plastic Surgery.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 67 reviews

Tethering after breast implant

Hi 611

From your photos, it appears that you've had your implant placed via a peri-areolar incision and that you have tethering in the lower/inner quadrant of that breast.

If your tethering gets worse when you press your hands on your hips, then it is likely due to the muscle release scarring up onto the skin. If this muscle contraction does not change the tethering, it will be due to other reasons for scarring such as diathermy during the procedure or a localised haematoma that has scarred up.

It is likely that your best result will be with revision surgery. The cause of the tethering will determine what surgery is required. It may be as simply as a scar release, but could be as complicated as needing acellular dermal matrix to reshape that area of the breast and prevent further scarring. Fat grafting over the area may help camouflage the problem, but you do need to understand the pros and cons of this approach.


3 Mos. Post Op Right Breast Looks Deformed, Mishaped, Can Feel Implant at Bottom of Breast Why? (photo)

Please post better photos! But you have the muscle indentation effect. Only revisional surgery will correct. 

Why a crease after augmentation?

Without knowing what you looked like, its hard to speculate.  Regardless, your surgeon has a vested interest in your having a satisfactory outcome and you should discuss your concerns with him/her.  If its simply a crease defect, fat grafting can make it better.  If the muscle distorts that when contracting muscle, it can be released.  Best to still discuss with your doctor and  hopefully he/she has a good revision policy.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Muscle Contraction Deformity

This double bubble appears to result from a muscle contraction deformity, which can be treated with a capsulectomy, releasing the portion of the muscle that is strongly affixed to the implant capsule and causing the indentation when you contract your muscle. 

Indentation along breast

That indentation may be several things.  Usually it is the muscle with animation. It would have to be seen in person to be evaluated. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Unusual Fold after Breast Augmentation

Thank you for the photo.  That is unusual. I feel that I don't have the complete story.  Could you give more details including preop pictures?  Providing that info will get you a good consensus of what the issue is and what can be done to remedy it.

3 Mos. Post Op Right Breast Looks Deformed, Mishaped, Can Feel Implant at Bottom of Breast Why?

It looks like you have a double bubble...is this an animated (tensed muscle) view or at rest?  If it's at rest but does not get worse with animation, then just releasing the inframammary crease may be adequate.  If it's all the time and/or gets worse with animation, then you may need to consider inserting ADM (Acellular Dermal Matrix, such as Alloderm or Strattice) in addition to the release.  Either way, you should be examined in person to confirm as you would need another surgical procedure to address this.


Dr. E

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