What can I do about my "double bubble" and stretched areolas? 7 mo. post op breast implants with periareolar lift (photo)

I am 25, 5'8" 140 lbs. My breasts have always sagged since puberty. When consulting different plastic surgeons, I received a few different opinions on a breast lift. Two said no, one said yes, one said periareolar. I went with periareolar and 375cc saline under the muscle. Immediately after surgery I was thrilled with my look. Over time, most importantly, my areolas stretched out. Then I started seeing this "double bubble". I would like to aim for the simplest, most cost effective solution.

Doctor Answers 7

7 Months Post Op

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Thank you for the question and photos. Your implant pockets may need to be revised. If you would like a more lifted look and reduction in areola size a full lift with permanent sutures around the areolas to prevent spread would be helpful. I recommend that you see your Plastic Surgeon in person for assessment and advice.
All the best


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It looks like you need a revision with repair of the fold and revision of the circumareola incisoin with a permanent suture to limit the spreading.  Good luck.

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


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If you are generally happy with your results, a repair of your inframammary fold from the inside to correct your double bubble and a redo of your periareolar lift would be fine.  If you would like a significant elevation of your implant, then a vertical lift would be indicated.  Best wishes, Dr. T. 

Double bubble

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Thank you for your question. I recommend seeing your plastic surgeon for possible revision. You will need to re-create your breast fold with an internal Ryan flap and areolar reduction. Your own plastic surgeon would be the less expensive route as he/she performed your first procedure. Best wishes

Johnny Shea-Yuan Chung, MD, FACS
Allentown Plastic Surgeon

Bottoming out and areolar stretch

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Unfortunately, the areolae stretch happens with aug/mastopexy and will likely not get any wider. The double bubble/bottoming out is more of an issue. It looks like the implants just opened up the fold more than planned and now the pocket needs tightening. If the position of the breast is still a concern, you may consider a "standard" lift with vertical incisions. But, if not, it will require a full procedure and removal of the implant to access the fold and tighten it through the periareolar incision. Spend some time with your doctor about options. This is not an unusual circumstance but should be addressed.

Breast lift result

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Your areola appearance is why I stopped doing periaerola lifts years ago. A few surgeons seemed to have mastered the no stretch areola post op , but not me or most results I see from others. I would probably recommend converting to a vertical style or lollipop lift which will reshape your breast and stablize the aerola size and shape. Hopefully the cause of the double bubble could be seen through the incision and addressed at the same time. Good luck.

The right size for you

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It is very difficult to determine the best lift you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

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.