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.