My PS says I'm going to end up with double bubble. Will it fade out?

I'm a 32A and my PS told me my IMF are asymmetrical so my right crease will need to be lowered. He said my left breast is where it should be so no lift if necessary. If I go to 400cc's, is it possible that my old crease will fade out? I'm really curious to know what it will look like before I schedule the surgery. I'm also curious if 400cc's under the muscle (saline, mod plus) will get me to at least a 32D. Any advise or even pictures would be really helpful.

Doctor Answers 3

Large implants produce double bubble

At size 32 A each 100 cc’s of implant corresponds to 1 cup size change. 400 cc implants would take you up 4 cup sizes to a DD. If this is attempted, the implants will displace inferiorly and laterally requiring revision and you will be dissatisfied. 22% of women who undergo breast augmentation require a repeat surgery within 2 years because of dissatisfaction with the results. I always recommend small round textured silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. If a lift is necessary this can be done simultaneous. Using this technique, it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. This will also reposition the inframammary crease if needed and avoid the double bubble.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Double bubble?

Your surgeon seems to be preparing you for a potential less-than-perfect outcome. That might well be honest and appropriate, but without a personal examination or at least photos of your anatomy, it really is impossible to predict.

And that is true regardless of implant size. You don't list your height or weight, only that you want to go from a 32A to "at least 32 D." 32 implies a smaller more petite frame, but I would think you need somewhat larger implants to go up "at least" 3 cup sizes. And of course, that also depends on the bra manufacturer. Goal photographs and trying on sizers in a bra and a stretchy top can help your surgeon determine more closely the best implant size and profile to achieve your goals--much better than simply stating a cup-size goal.

If you are petite as I think you must be (32 A, narrower-profile implant choice), then I would suggest silicone gel submuscular implants--saline implants in a thin, small-breast woman, especially submammary, would likely both feel unnatural and have visible or palpable rippling.

Double bubble can occur with silicone or saline, and the younger and more-firm your skin and tissues are, as well as the degree of "sharpness" of your present Inframammary crease (IMC), will determine whether or not a new crease can be created without the "old one" still being visible. Over time, a visible double bubble can diminish, but this happens more with loose or more stretchy skin (older patient), less well-defined crease (more of a curve than a sharp line), and the more weight of the implant (size) the better to help stretch and round-out the old IMC.

Don't' go for Cheap; go for once and best, even if it costs a bit more. Think about the "cost" of repeat surgery to get it right, not just the dollars, but the time off, risks, and the possibility that your best outcome is obtained the first time if all the proper decisions are made. Consider another consultation or two with ABPS-certified plastic surgeons. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Double Bubble

Any time that you try to lower the inframammary fold, you are at risk of having a double bubble deformity, especially if your folds are tight. If you don't have significant asymmetry of the folds, I often don't try to lower either one. The breast can still be fairly even and you don't have as much chance of getting a double bubble.

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 72 reviews

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