Tuberous breasts surgery gone wrong? (Photos)

Question

I had my surgery on 2nd March, i know it is soon to complain about the final result but I don' t think it is a good one. I got Eurosilicone round gel implants, 80% filled, 375 grams. I have the incisions under my armpits. My breasts have this double bubble look and my PS told mw to not worry because in a few months my breasts will look nice. Please let me know what do you think, I start to regret I did this surgery. Thank you.

Jerome Edelstein, MD · Answer

Hello,Thank you for your question and photos. Your frustration is understandable however the breasts could change drastically in appearance as you heal and the previous folds slowly expand and smooth out. If this does not improve significantly you will need to speak with your Plastic Surgeon about options to further improve things in the future. Please allow at least 6 months to evaluate your results.All the best

Christian Subbio, MD · Answer

It appears that you do indeed have a double bubble deformity.  Usually this will get somewhat better with time, depending upon how much release internally your surgeon did at the lower portion of the breast.  It may not get better at all.  Only time will tell, so keep in contact with your plastic surgeon as things evolve over the next 3-6 months.  Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Anthony Deboni, MD · Answer

Thanks for your question and photos.  It appears that you have a double bubble, with the original crease sitting above the lower border of the implant. It is too early to tell whether your appearance will improve, but I recommend that you give it time to settle and heal.  It does appear that you had very discrete breast tissue pre operatively, and that you chose a fairly large implant.  Both of these can increase the risk of double bubble.  I suggest that you allow the surgery to heal and settle, and then discuss the concerns with your surgeon.  Best Regards

Payman Danielpour, MD, FACS · Answer

Your concerns are valid and should be expressed to your plastic surgeon.  The ultimate result is normally due to planning prior to the surgery,  You have a double bubble that needs to be addressed but I would wait 3-6 months prior to any surgical revision.

Aldo Guerra, MD · Answer

Thanks for the opportunity to answer this questions for you. It's too early to tell what your final result will be like at this point. I suggest you be more patient. 
Double bubbles do get better over time and many completely resolve. I suggest you follow closely with your plastic surgeon and use him/her as a resource to predict how well these will disappear over time. At this point, I think you're healing fine and you don't need to stress about this situation. If the folds are still visible after one year, switching to a tear drop or fat injections or both procedures are some options in your future. 
Best wishes, Dr. ALDO :)

Scott E. Kasden, MD, FACS · Answer

Hi xtinacris
I see two basic issues with your surgical result.  First you have incomplete release of the constricting bands around the areolas.  Your preop pics don't really show a constricted breast, but as will happen, it is present and exaggerated by the implant which pushes the breast tissue through the constricted ring.  The rings were not adequately released and therefore the deformity is worsened.
The other technical issue is a constriction at the base of each breast causing a "double bubble"  This is due to dense connective tissue under the Pec Major Muscle.  Since this constrictive band was not adequately divided, it prevents the round shape to be expressed in along the course of the band, causing the double bubble.
I am sorry to tell you that you but these issues can only be corrected surgically.
All the best.
sek

Tania Medina de Garcia, MD · Answer

Hello dear!Thanks for the question and provided photos as well, and I'm sorry you are not happy with the results. I think you could have better results, but certainly, your PS is also true; it's too soon to know the results, because your breast are very swallow (it's normal), and the breast change a lot in the next months. So, i recommend you to keep in touch with your plastic surgeon, be patient and positive.Good luck :)

Chen Lee, MD · Answer

Double bubble results from lowering a shortened nipple to inframammary fold distance so that a breast implant will remain centred on the nipple.  An indentation results from the old inframammary crease pressing on the implant.  Occasionally, this will improve as the tissue stretches at the fold in respond to pressure from the implant.  This process might take months.  Continue with you followup visits.  If spontaneous improvement is insufficient in 6 months, your surgeon will review possible options to address this problem.

Frank Conroy, MBChB, MRCS, FRCS(Plast) · Answer

Whenever a tuberous breast procedure is performed and the infra-mammary fold is lowered there is often 'memory' left.  The anatomical landmark has been violated and the line you are seeing is where the old IMF once was.  The surgeon will have needed to lower the fold due to insufficient lower pole  skin (a classical finding in tuberous breasts).  With time this fold will soften as the implant drops and with the bandeau in place this should help speed the process up.  
I wouldn't worry at this stage, things are heading in the right direction !

Tom J. Pousti, MD · Answer

I do see your concern. Although it is too early to evaluate the final outcome of the procedure performed, I would be agree that you do have a "double bubble" present. A "double bubble" is a cosmetically undesirable circumstance for patients with breast implants, which occurs when the breast fails to take on the shape of the implant, resulting in the appearance of a visible line showing a separation between the bottom edge of the implant and the bottom edge of the natural breast.  Sometimes, in situations like yours, the appearance of the breast improves over the course of the first several months; sometimes, additional surgery may be necessary to improve the outcome.
There are several options when it comes to revisionary surgery to improve your outcome.  One option is to eliminate the pull of the pectorals major muscle either by completely releasing it or by suturing the muscle back down, thereby placing the breast implants  in the sub glandular position.  Patients who choose to have breast implants placed in the sub  glandular position should have enough breast tissue coverage to allow for this conversion. There are disadvantages of placing breast implants in the sub glandular position (such as increased risk of breast implant encapsulation) which should be considered as you make your decisions.
Another maneuver that may be helpful is raising the inframammary fold using capsulorraphy techniques. Sometimes, depending on factors such as quality of skin along the lower breast poles, additional support provided by acellular dermal matrix or biosynthetic mesh may be very helpful. I have also found the use of acellular dermal matrix very helpful in cases where the skin/tissues are very thin and in cases of recurrent breast implant displacement. The acellular dermal matrix helps improve contour, improves irregularities caused by the underlying breast implant and/or scar tissue, and provides additional support ("sling" effect) for the breast implants.
I hope this, and the attached link, helps.
Best wishes.

Tuberous breasts surgery gone wrong? (Photos)

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