I have double bubble 9mo postop. My doctor wants to do fat injections. What should I do? Did my doctor do a poor job? (Photo)

I'm 9months PO. I had a breast aug with 335 allergan 410MF implants. I have double bubble and my implants are wide. My doctor wants to do fat injections in the cleavage and under the breast. I've heard that fat injections interfere with cancer detection and can become hardened. Should I do this? Will the double bubble improve over time? Should I have gotten round implants? And finally, should I have to pay another $8500 to have my breasts redone after I already paid $12,000 for my first surgery?

Doctor Answers 6

Consider moving breast implants to sub glandular position.

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More history is necessary but if the implants are sub muscular the vector of force from the pectoralis muscle can push the implants in an inferior direction. This can be corrected with silicone gel implants in a sub glandular position. I personally do not charge my patients for revisions.

Double bubble treatment

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  • You have a double bubble and need the crease of the breast re-created.
  • You need to plan for new implants although often the original ones can be reused.
  • I do not think fat implants will make this better - they may partially conceal but will not fix the problem.
  • The fee you are quoted may be fine for fat transplants but it seems high for what you need done, since it is a revision of your first surgery. Best wishes.

Challenging questions

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but if you like your size and breast location, focus on the fat grafting.  Many surgeons would consider this a 'revision' unless you were told about this before your procedure and would come with reduced costs.  Otherwise the other options mentioned by the others could be pursued but would require returning to the OR, new smaller implants, and surgery that is unpredictable (elevating implants).  Round implants of the same size would have created the same result.  When my patients are faced with the possibility of a double bubble, they are asked to choose between being the size they would like or be smaller to avoid the crease.  In my opinion, the upper pole being level is much more important than the appearances of the lower pole since that is what the public sees, unless you always exposed.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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Double bubble 9 months post op

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It appears from your pictures that you have implant malposition.This problem will not resolve over time without treatment. There are several options that are available to correct this problem. Capsulorraphy , tightening the pocket around the implant would be one of the most common procedures to reduce the double bubble. Capsulorraphy is the option that I would recommend for your case.  Another option would  require changing the location of the implants from sub-muscular to sub-glandular. Fat grafting is also another option. However, it is possible to get  fat necrosis or scaring from the fat grafting. This problem isn't related to the shape or style of implant.  While I personally don't charge for revisions this is something that should be discussed with your surgeon.

Jon E. Rast, MD
Kansas City Plastic Surgeon
5.0 out of 5 stars 35 reviews

Double bubble after breast augmentation

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Your surgeon sounds like someone who is experienced with breast surgery.  Style 410 implants are implants that not every surgeon is comfortable using because there are a few more technical challenges during planning and the surgery than with round implants.  Fat grafting to correct double bubble deformity is also a newer technique, some might even say "cutting edge".  Other options are available too, like changing from under the muscle to over, or revising the scar tissue capsule internally.  As far as paying for revision surgery, this type of situation is handled differently by different surgeons depending on the discussions and educational process that take place prior to surgery.  While the experience has probably been disheartening to you, probably the main thing for you to do at this point is have clear and consistent conversations with your surgeon. Only by understanding the options, the risks, and the benefits will you be able to make choices that work best for you, and your surgeon should help guide you during this process.

Kelly R. Kunkel, MD
Fort Worth Plastic Surgeon

I have double bubble 9mo postop. My doctor wants to do fat injections. What should I do? Did my doctor do a poor job?

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I am sorry to hear about the concerns you have after breast augmentation surgery.  Based on your photographs, you seem to be experiencing some degree of breast implant displacement ( breast implants sitting somewhat low on your chest wall and low in relation to the nipple/areola complexes).  Revisionary breast surgery may be helpful in improving your situation.  Although there are often several ways to approach a specific “problem” in plastic surgery,  the approach I would use in your case would likely involve internal sutures (capsulorraphy)  to “reconstruct” the inframammary fold areas.    This procedure involves removal of a segment of breast implant capsule among the inferior/lower aspect of the left breast implant pocket. The 2 edges of  capsule tissue are sutured to one another. This procedure reduces the size of the implant pocket and prevents the descent  of the implant on the left side. This procedure will improve the symmetry of the breasts  and the positioning of the nipple–areola on the  breast mound.

 I hope this, and the attached link (dedicated to revisionary surgery concerns), helps.

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.