This is an update to my previous post. Is my right breast a double bubble and will switching to smaller implants correct it?

My post was confusing, the pictures were not labeled. The first pic is PRE OP. In July I had silicone, under muscle 405cc's placed in right breast , left breast had a lift with 395 cc's. Left breast had hematoma two weeks post op. It looks as if it is sagging and was told revision might be needed in six months. My concern is the right breast in 2&3 pics. I feel the implant, it hurts badly in a bra. There is no crease. Dr. claims it will correct, I am rushing process. Thank you for your help.

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Doctor Answers 6

Breast augmentation question

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From your previous photos it looks like you have a double bubble deformity. The crease may soften as you tissue stretches with time. It's best to wait 3 to 6 months or longer before making any final  and judgments. At that time if the issue still exists revision surgery may be necessary. Switching to smaller implants alone usually does not correct this issue.

Double bubble

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You may have a double bubble, or drooping of the breast tissue over the implant.  This can be related to malposition of the implant, or the need to lift the breast tissue to the proper position.  I would not recommend any revision surgery for at least 6 months to allow the tissues to heal.  It's best to be patient in these situations and communicate with your surgeon.  Good luck!

Brian A. Pinsky, MD
Long Island Plastic Surgeon
5.0 out of 5 stars 6 reviews

Double bubble or hanging breasts or both?

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I sorry to hear what you are going through, and it definitely must be frustrating.

In this answer, I will try to address your photos and your concerns.

Your pre-op photo in the previous question shows significant sagging (ptosis) in both breasts. So I am unsure why only your left breast received a lift. When you get a breast augmentation without a lift, you put yourself at risk of any of the following: the implants appearing too low on your chest (bottoming out), the sagging will worsen quicker because of the added weight of the implant, you may have hanging breasts (i.e., your breast tissue appears lower than your breast implant), or you may have double-bubble deformity where the implant underlying the breast tissue droops below the natural crease/fold of the breast.

To be more specific, double-bubble refers to 2 distinct folds underneath the breast where the bottom one is from the implant, and the one higher up is from the natural breast tissue. This happens when the implant chosen is too big, or if there was an improper dissection of the inframammary fold ligament that is attached to the breast tissue. This ligament is coming from the pectoralis muscle, and when this is not released, then the natural breast fold persists above the fold created by the implant. To correct it, you may place a smaller implant, release the inframammary fold’s connection with the breast tissue, transfer your own body’s fat to camouflage the two fold depression under the breasts, or restore the original breast fold.

Regarding your right breast, the pictures do not do justice in providing a clear look. The third image seems to show a crease below the breast tissue, but I may be wrong. You mention there is no crease, so I am unsure what you mean, but it seems that the natural breast fold is persistent resulting in a double bubble, and it also seems that your breast is hanging off the implant which happens when pre-existing sagging was not addressed. Now if you can feel the implant, and right breast feels hard, and painful, then another possibility is that you may have capsular contracture which occurs when the naturally formed scar tissue starts to tighten around the implant. If the pain is only there when you touch the breast, it may just be that you have hypersensitivity which will go away in a few months.

Since you had the breast augmentation over 2 months ago, you may have to wait a bit more to achieve the final results which happens in 3-6 months. I truly apologize, but nothing can be conclusively said about your breasts without an in-person breast exam and consultation.

It would be in your best interests to continue to have regular follow-ups with your surgeon to make sure your breasts are healing. Their recovery instructions should take precedence over all else you read here as they are better informed about your surgical details. If you are doubtful regarding their advice, you may have a second-opinion.

I hope this alleviates some concerns if not all.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Breast issue

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No photos seem to be posted along with the question. It is best to repost with photos. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

No photos attached

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No photos seem to be attached to the post - please post photos in order to advise further regarding possible double bubble

May improve

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You now have a transition problem from your breast tissue to your chest tissue.  This may improve with time.  Some slight imperfection has to be tolerated as the problem is difficult to correct.

Best Wishes,

Nana Mizuguchi, MD

Nana N. Mizuguchi, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 55 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.