Double bubble or normal drop and fluff process (not perfectly at same time)? (Photo)

By ten weeks post op, most of the swelling in the breasts has resolved, and most implant settling has ocurred. The double contour seen in your pictures is what is referred to as a " double bubble" . It is most commonly associated with submuscular implants. Certain breasts are more at risk for this occurrence and measures can be taken at the time of surgery to minimize the problem. If it is minimal, and you are not too concerned, nothing has to be done. If you wish to correct it ,revisional surgery will be needed.

Hi NJ335,

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

Thank you for sharing your question and photographs.  Though offering limited views it is difficult to know if a true double bubble exists.  I see the irregularity under your left breast and if that fullness feels like an implant it is most likely one.  If it feels swollen or like breast tissue it may still improve in appearance over the next several months.  Discuss your concerns with your surgeon, as they know the full details of your procedure.

your photo shows some irregularity in the lower part of that breast. It doesn’t like a true double bubble deformity yet but may change.  If it stays the same you can typically have it revised close to a year with a small surgery 

 a double bubble. however the photos are very limited with what you provided. You will likely get better answers with some better pictures

Hello,
It does appear to be a double bubble developing on your left.  It is still early, this could persist or could worsen.  If it worsens, surgery will be needed to fix.  Be patient and maintain a good relationship with your plastic surgeon.  Good luck
ABPS board certified plastic surgeon

Dear NJ,The photos are not great, but it does resemble a small double bubble.  The old crease may still stretch out with time and massage.  You are still early in the healing process.  Follow up with your surgeon for their evaluation and suggestions.Best of luck.Dr T

Good morning and thank you for your question and photos.  It is very early yet in the healing process and this may still settle as the implant settles.  It is normal for the two to settle at different rates, however be sure to be checking in with your surgeon to have your progress and healing tracked.  Best of Luck!Dr. K.

Unfortunately, you have an implant that is dropping low, because of lack of good soft tissue support. I like to do a popcorn capsullorhaphy or tightening followed by placement of a very new type of internal bra material. This material can make you up to four times stronger and help prevent the type of failure of support that occurred in the first place. We would love to tell you more in a private consultation.We are always happy to see any and all patients. We also offer telemedicine / online consultations for your convenience.
M. Kara, MD, FRCSC - Over 30 Years Experience
Specializing in Out To Dinner / 24 Hour Recovery Breast Augmentation.
Offering Saturday Consults, Surgery, and Followups - Never miss a day off work!
Operating from an “in-hospital” certified, private surgery centre for your safety and peace of mind!

It's hard to tell from your photos.  You may have a small double bubble.  I would highly recommend you see your surgeon for an evaluation.