Best approach to fix double bubble and flex deformity? 6 months post op (Photo)

Dear ChicagoBorn,   Thanks for posting your before and after pictures and sorry for your disappointing result. From observing your pictures, your problem is not implants size but rather double bubble deformity  and bottoming out due to excessive lowering of the sub mammary creases and possibly superior capsule contracture.    Unfortunately, the only solution for your problem is surgery. You will definitely need inferior capsulorrhaphy ( internal bra) to raise the creases, which will correct the flex and double bubble deformities . Also, most likely, you will need  superior  capsulotomy ( scar release) , to allow the implants to move upward into a more attractive and youthful position.    As you can see from your own experience, not all results are the same, because experience, technical skills and aesthetic eye are critical for good outcome. So, this time,  do your due diligence carefully and choose your surgeon wisely.      Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of redo breasts augmentation in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.                            Best of luck,                                        Dr Widder

 Going to the larger size is not what caused the problem, and you did not make a mistake. I would recommend at this point you consider taking the implants out from under the muscle and putting them on top of the muscle with a new pocket. Your implants are going to the Lowe and the muscle is causing the distortion. By placing them in front of the muscle you will not have the distortion you can form a new park in the proper position. Good luck,Greg Sexton, M. D.Columbia, S. C 

The key is should you find a new board certified plastic surgeon or let the same doc try to fix. Looking at your pics I think a little smaller 325cc moderate plus would be so would be a better fit but none the less your surgery appears to have left you with a bad result. You will not 100% eliminate contraction deformity with repair unless you go above the muscle. You unfortunately are going to spend at least twice the original cost for a revision so choose your doctor carefully. I agree a tissue type product such as Alloderm will be of benefit you to improve the repair stability. Good Luck and update us please.

It appears your implants are too low. This can certainly be improved if not fully repaired. I like to use Galaflex in cases like yours to help maintain the correction. Good luck. Sorry this happened to you. 

Hi and thanks for your question.  I'm sorry that you're in this situation.  Double bubble and flexion deformity can be related but are two separate problems requiring two separate fixes.  The flexion deformity is because either the muscle wasn't released enough or because your muscle just moves a lot when it flexes.  Either way moving it over the muscle is the only way to get rid of it completely.  The double bubble is because your original breast crease was released and it was lowered to make enough room for the implants chosen.  The problem is that if you don't release the breast tissue enough along with the fold, the original crease will remain as an indent and will be visible.  In addition, if nothing was done to support the new breast crease, the likelihood of the implants dropping more is high.  What I would recommend is a revision incorporating movement of the implants over the muscle, downsizing your implants, converting to a gummy-style textured implants and reconstructing your original breast fold.  Best of luck!

The implants are too low due to an overdissected pocket. The sizing is fine. Repair involves tightening the capsule and I would use Galaflex mesh to support the repair. This should correct the animation issue as well. 

So sorry to hear you are having these issues after your breast augmentation.  Rest assured the implant size you chose was not a mistake and did not contribute to this issue in your case.  Bottoming out or malposition of your implants leading to the "double-bubble deformity" is a known complication of breast implant surgery and should be corrected with repair of the capsules at the bottom as well as surgical release of the capsules at the top.Without a one-on-one consultation and examination, I am not sure you would benefit additionally from moving your implants to above the muscle.  The "flex deformity" ("animation deformity") should no longer be an issue once the above capsule repairs are performed.  I have not found it necessary to add ADM (Galaflex, Alloderm, Strattice) for additional support in repairing the double-bubbles.  This adds additional cost that has been proven to be unnecessary in my practice.  Best wishes to you for an excellent result.

Dear ChicagoBorn:  Thank you for your photos.  -It appears that the implant has descended and is very low on the chest wall-the inframammary fold may have been released during surgery and continues to lower-there upper pocket may also no longer be openCertainly revision surgery is necessary to:-elevate and recreate the fold-release the capsule where needed especially the upper pole-this should help correct the animation (flex) deformityMake sure your surgeon is board certified in plastic surgery.Getting second opinion(s) can help you decide the best course.Best wishes.Louise Ferland MD FRCSC, Board Certified Plastic Surgeon and Active Member of the American Society for Aesthetic Surgery.