Double bubble revision, 405cc to 460cc, lowering fold on left side. Best course of action? (photos)

Question

I had 405cc round implants placed under the muscle December 2021. My breasts before surgery were deflated and drooping after breastfeeding. The left inframammary fold was lowered. This side now has a double bubble deformity and this breast appears higher and smaller. To revise the issue, the surgeon suggests switching to a 460cc implant on the left side, scoring and possibly lower the fold more. I am responsible for payment again. Is this the best course of action? Thank you!

Daniel Barrett, MD · Answer

Dear btay136,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gianfranco Frojo, MD · Answer

In my opinion, breast augmentation alone was not the correct surgery from the beginning. You needed a breast lift at the time of implant placement. The oversized implant that was placed is too powerful for your tissues. This resulted in an elongated right breast lower pole and left implant bottoming out with obliteration of the native inframammary fold onto the lower pole of your left breast, this is the reason for the "double bubble". I would proceed with extreme caution if pursuing any further surgery. My official recommendations would be to completely downsize both implant, perform capsular tightening/suturing, potential placement of a supportive scaffold in the pocket, and bilateral breast lifts. Best of luck!

Richard Baxter, MD · Answer

Your pictures are typical of animation deformity related to traction of the muscle where it was cut for dual plane method. If you see the crease pulling up when you flex the pec then that is the cause and requires a specific type of correction. The reason I suspect this is because the distance from the nipple-areola to the crease is much shorter than it was in the pre-op or on the other side, suggesting that it isn't the original inframammary fold. Correct this by converting to the split muscle plane with muscle re-attachment behind the implant. Many examples on my website.

John Michael Thomassen, MD · Answer

It may be possible to just readjust the fold that caused the double bubble to remove it without replacing the implants.  This would make it less costly than replacing the implants.

Connie Hiers, MD, FACS · Answer

The implant on your opposite side is sitting somewhat low, so I would recommend raising that side and going down in size, and correcting the fold on the other side.  I doubt your thin tissue will support weights over 400 cc's.

Double bubble revision, 405cc to 460cc, lowering fold on left side. Best course of action? (photos)

Answers (5)

Answer: Capsulorrhaphy

Answer: Capsulorrhaphy

Answer: Implants

Answer: Implants

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Everything you need to know about Breast Implant Revision

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Double bubble revision, 405cc to 460cc, lowering fold on left side. Best course of action? (photos)

Answers (5)

Answer: Capsulorrhaphy

Answer: Capsulorrhaphy

Answer: Implants

Answer: Implants

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.