Can I prevent double-bubble again in the future? (photo)

It seems you could get a very nice result with a revision. I do not believe you need to live with a double bubble. You would almost certainly require general anesthesia, and a strong lasting breast lift would almost certainly need a vertical scar, and not be done through the armpit.

Dear Lisa Wu,

though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Your implants had to be placed low because your breasts were low and this has resulted in the double bubble. The technique I recommend is explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

An in person evaluation is needed to know for sure but from the provided photos it appears you will need to consider a breast lift with your augmentation for the best outcome. Mesh can help support the tissues and the weight of the implant to lower the risk of double bubble, but it appears the issue for you is skin laxity. A breast lift is the recommendation to correct that.

No, the breasts cannot be lifted with the armpit incision. With a double bubble, you need to go smaller. Your implant is too large and heavy for your tissue and sags down. Looking at your photos, the implants are too large for your breast base. Smaller implants are lighter and stay in place better. You might need more mesh. Your tissue would probably do much better with 350-400 cc implants, but not larger. The bigger the implant, the more stretching and thinning occurs to your own tissue and the less your tissue will support.